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General NPI Number Information
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NPI Number | 1619472081
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Entity Type | Organization
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Legal Business Name | STONEY CREEK TOWNSHIP MADISON COUNTY
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 03/28/2018
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Provider Practice Location Address
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Address Line | 8871 W 200 S
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City | LAPEL
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State | IN
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Zip | 46051-9712
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Country | US
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Telephone | 765-534-3747
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Fax |
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Provider Business Mailing Address
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Address Line | 8871 W 200 S
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City | LAPEL
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State | IN
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Zip | 46051-9712
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Country | US
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Telephone | 765-534-3747
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Fax |
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Authorized Official
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Title or Position | TRUSTEE
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Name | DIANE LAWTHER
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Credential |
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Telephone | 765-620-9421
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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 | 0049
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License Number State | IN
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