Healthcare Provider Details

I. General information

NPI: 1821360876
Provider Name (Legal Business Name): LAKE HILLS VOLUNTEER FIRE DEPARTMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2012
Last Update Date: 11/11/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9105 W 85TH AVE
SCHERERVILLE IN
46375-2518
US

IV. Provider business mailing address

9105 W 85TH AVE
SCHERERVILLE IN
46375-2518
US

V. Phone/Fax

Practice location:
  • Phone: 219-365-3340
  • Fax: 219-365-3523
Mailing address:
  • Phone: 219-365-3340
  • Fax: 219-365-3523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0462
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: RACHEL WILKINSON
Title or Position: EMS BILLING MANAGER
Credential:
Phone: 219-365-3340