MEDICARE: FIRE DEPARTMENT OF LIBERTY TOWNSHIP HENDRICKS COUNTY INDIANA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	0085	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023067832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRE DEPARTMENT OF LIBERTY TOWNSHIP HENDRICKS COUNTY INDIANA INC

Provider Business Mailing Address
First Line	:	PO BOX 50890
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-0890
Country	:	US
Telephone Number	:	317-849-6628
Fax Number	:	317-849-6632

Provider Business Practice Location Address
First Line	:	111 EAST KENTUCKY STREET
Second Line	:
City	:	CLAYTON
State	:	IN
Zip	:	46118-9482
Country	:	US
Telephone Number	:	317-775-6753
Fax Number	:	317-849-6632

Authorized Official
Title or Position	:	EMS CHIEF
Name	:	MR. ALAN MCKAMEY
Credential	:
Telephone Number	:	317-775-6753

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	05/11/2023

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