MEDICARE: DECATUR CIVIL TOWNSHIP

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	0093	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
2	000000191138	OTHER	IN	BCBS

General Provider Information

NPI Number	:	1154386845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DECATUR CIVIL TOWNSHIP

Provider Business Mailing Address
First Line	:	5410 S HIGH SCHOOL RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46221-4044
Country	:	US
Telephone Number	:	317-856-5400
Fax Number	:	317-849-6632

Provider Business Practice Location Address
First Line	:	5410 S HIGH SCHOOL RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46221-4044
Country	:	US
Telephone Number	:	317-856-5400
Fax Number	:	317-849-6632

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	PASCAL ARNES
Credential	:
Telephone Number	:	317-775-6753

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	08/03/2023

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Directions to “DECATUR CIVIL TOWNSHIP ” Practice Location

Language	Start Address	Practice Location

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