MEDICARE: TOWN OF EVANSVILLE

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

General Provider Information

NPI Number	:	1427306265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWN OF EVANSVILLE

Provider Business Mailing Address
First Line	:	PO BOX 158
Second Line	:
City	:	EVANSVILLE
State	:	WY
Zip	:	82636-0158
Country	:	US
Telephone Number	:	307-234-6530
Fax Number	:	307-266-5109

Provider Business Practice Location Address
First Line	:	500 SECOND ST
Second Line	:
City	:	EVANSVILLE
State	:	WY
Zip	:	82636-0158
Country	:	US
Telephone Number	:	307-234-6530
Fax Number	:	307-266-5109

Authorized Official
Title or Position	:	TOWN TREASURER
Name	:	MRS. PEGGY S NADING
Credential	:
Telephone Number	:	307-234-6530

Provider Enumeration Date	:	08/28/2012
Last Update Date	:	09/28/2012

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Directions to “TOWN OF EVANSVILLE ” Practice Location

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