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General NPI Number Information
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NPI Number | 1003868548
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Entity Type | Organization
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Legal Business Name | PORTAGE TOWNSHIP PORTER COUNTY
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 398 W 700 N
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City | VALPARAISO
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State | IN
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Zip | 46385
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Country | US
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Telephone | 219-759-3919
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Fax | 219-759-8068
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Provider Business Mailing Address
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Address Line | PO BOX 429
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City | LEWISVILLE
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State | NC
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Zip | 27023-0429
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Country | US
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Telephone | 734-224-4474
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Fax | 336-791-0196
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Authorized Official
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Title or Position | TRUSTEE
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Name | BRENDA CLANCY
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Credential |
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Telephone | 219-762-1623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 0067
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License Number State | IN
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