Healthcare Provider Details

I. General information

NPI: 1881700953
Provider Name (Legal Business Name): TOWN OF PLAINFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 MOON RD
PLAINFIELD IN
46168-8797
US

IV. Provider business mailing address

PO BOX 65
PLAINFIELD IN
46168-0065
US

V. Phone/Fax

Practice location:
  • Phone: 317-754-5180
  • Fax: 317-838-3716
Mailing address:
  • Phone: 317-839-2561
  • Fax: 317-838-5236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number0044
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0044
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier100452640
Identifier TypeMEDICAID
Identifier StateIN
Identifier Issuer
# 2
IdentifierP00103861
Identifier TypeOTHER
Identifier State
Identifier IssuerRAILROAD MEDICARE

VIII. Authorized Official

Name: MR. BRENT ANDERSON
Title or Position: FIRE CHIEF
Credential:
Phone: 317-754-5180