MEDICARE: CITY OF SHELBYVILLE & SEWAGE WORKS OPERATING

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	0176	IN

General Provider Information

NPI Number	:	1811316383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF SHELBYVILLE & SEWAGE WORKS OPERATING

Provider Business Mailing Address
First Line	:	40 W BROADWAY ST
Second Line	:
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-1256
Country	:	US
Telephone Number	:	317-392-5119
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 W BROADWAY ST
Second Line	:
City	:	SHELBYVILLE
State	:	IN
Zip	:	46176-1256
Country	:	US
Telephone Number	:	317-392-5119
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	MR. DOUG LUTES
Credential	:
Telephone Number	:	317-775-6753

Provider Enumeration Date	:	04/14/2014
Last Update Date	:	07/10/2024

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