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General NPI Number Information
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NPI Number | 1265436166
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Entity Type | Organization
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Legal Business Name | PUTNAM COUNTY OPERATION LIFE, INC.
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Dates
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Enumeration Date | 06/08/2005
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 513 S BLOOMINGTON ST
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City | GREENCASTLE
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State | IN
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Zip | 46135-2113
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Country | US
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Telephone | 765-653-3600
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Fax | 765-653-5893
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Provider Business Mailing Address
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Address Line | PO BOX 502250
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-7250
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Country | US
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Telephone | 317-849-6628
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Fax | 317-849-6632
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ERIC J CLAFLIN
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Credential | NRP, FP-C
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Telephone | 765-653-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 670116
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 670116
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License Number State | IN
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