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General NPI Number Information
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NPI Number | 1639188154
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Entity Type | Organization
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Legal Business Name | WASHINGTON CIVIL TOWNSHIP
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 05/30/2018
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Provider Practice Location Address
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Address Line | 1834 W WALLEN RD
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City | FORT WAYNE
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State | IN
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Zip | 46818
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Country | US
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Telephone | 260-449-3671
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Fax | 260-449-3672
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Provider Business Mailing Address
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Address Line | 1832 W WALLEN RD
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City | FORT WAYNE
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State | IN
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Zip | 46818-1029
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Country | US
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Telephone | 260-449-3354
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Fax |
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Authorized Official
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Title or Position | TRUSTEE
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Name | ROBERT ARNOLD
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Credential |
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Telephone | 260-449-3354
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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 | 0337
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License Number State | IN
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