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General NPI Number Information
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NPI Number | 1407842164
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Entity Type | Organization
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Legal Business Name | MC AMBULANCE SERVICE, LLC.
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10770 N 600 E
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City | ODON
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State | IN
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Zip | 47562
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Country | US
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Telephone | 812-636-7888
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Fax |
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Provider Business Mailing Address
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Address Line | 10770 N 600 E
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City | ODON
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State | IN
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Zip | 47562
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Country | US
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Telephone | 812-636-7888
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. AMANDA WOODRUFF
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Credential | A-EMT
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Telephone | 812-636-7888
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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 | 0752
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License Number State | IN
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