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General NPI Number Information
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NPI Number | 1851459002
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Entity Type | Organization
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Legal Business Name | AREA 10 AGENCY ON AGING RURAL TRANSIT
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 630 EDGEWOOD DR
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City | ELLETTSVILLE
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State | IN
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Zip | 47429-1134
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Country | US
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Telephone | 812-876-3383
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Fax | 812-876-9922
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Provider Business Mailing Address
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Address Line | 630 EDGEWOOD DR
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City | ELLETTSVILLE
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State | IN
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Zip | 47429-1134
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Country | US
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Telephone | 812-876-3383
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Fax | 812-876-9922
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Authorized Official
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Title or Position | DIRECTOR
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Name | JEWEL ECHELBARGHT
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Credential |
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Telephone | 812-876-3383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 763020
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License Number State | IN
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