MEDICARE: HSALAMONIA VOLUNTEER FIRE DEPARTMENT

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	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1730313776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HSALAMONIA VOLUNTEER FIRE DEPARTMENT

Provider Business Mailing Address
First Line	:	5816 E NORTH ST
Second Line	:
City	:	SALAMONIA
State	:	IN
Zip	:	47381-9721
Country	:	US
Telephone Number	:	260-335-2905
Fax Number	:

Provider Business Practice Location Address
First Line	:	5816 E NORTH ST
Second Line	:
City	:	SALAMONIA
State	:	IN
Zip	:	47381-9721
Country	:	US
Telephone Number	:	260-335-2905
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	MR. LLOYD E WRIGHT
Credential	:
Telephone Number	:	260-335-2385

Provider Enumeration Date	:	05/05/2009
Last Update Date	:	05/05/2009

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Directions to “HSALAMONIA VOLUNTEER FIRE DEPARTMENT ” Practice Location

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