Provider Demographics
NPI:1003853375
Name:CITY OF NOBLESVILLE
Entity Type:Organization
Organization Name:CITY OF NOBLESVILLE
Other - Org Name:NOBLESVILLE FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-775-6753
Mailing Address - Street 1:PO BOX 502250
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-7250
Mailing Address - Country:US
Mailing Address - Phone:317-775-6753
Mailing Address - Fax:317-870-0499
Practice Address - Street 1:135 S 9TH ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2620
Practice Address - Country:US
Practice Address - Phone:317-770-1419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200262450Medicaid
IN200262450Medicaid