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General NPI Number Information
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NPI Number | 1801046347
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Entity Type | Organization
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Legal Business Name | MONROE HOSPITAL AMBULANCE SERVICE
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Dates
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Enumeration Date | 09/21/2008
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Last Update Date | 01/23/2009
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Provider Practice Location Address
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Address Line | 4011 S MONROE MEDICAL PARK BLVD
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City | BLOOMINGTON
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State | IN
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Zip | 47403-8000
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Country | US
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Telephone | 812-825-0904
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Fax |
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Provider Business Mailing Address
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Address Line | 4011 S MONROE MEDICAL PARK BLVD
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City | BLOOMINGTON
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State | IN
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Zip | 47403-8000
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Country | US
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Telephone | 812-825-0904
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Fax |
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Authorized Official
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Title or Position | CEO/MEDICAL DIRECTOR
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Name | DR. JONATHAN D HART
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Credential | MD
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Telephone | 812-825-0892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State | IN
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