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General NPI Number Information
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NPI Number | 1760605224
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Entity Type | Organization
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Legal Business Name | TRI-CREEK AMBULANCE SERVICE AGENCY, INC.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 1331 E COMMERCIAL AVE
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City | LOWELL
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State | IN
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Zip | 46356-2168
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Country | US
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Telephone | 219-696-8610
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Fax |
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Provider Business Mailing Address
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Address Line | 1331 E COMMERCIAL AVE
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City | LOWELL
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State | IN
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Zip | 46356-2168
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Country | US
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Telephone | 219-696-6108
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Fax | 219-690-1224
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Authorized Official
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Title or Position | TREASURER
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Name | MR. MICHAEL MCINTIRE
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Credential |
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Telephone | 219-696-8610
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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 | 0195
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License Number State | IN
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