Provider Demographics
NPI:1033422522
Name:ABOITE CIVIL TOWNSHIP
Entity Type:Organization
Organization Name:ABOITE CIVIL TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRUSTEE
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-432-0970
Mailing Address - Street 1:11321 ABOITE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46814-5472
Mailing Address - Country:US
Mailing Address - Phone:260-432-0970
Mailing Address - Fax:260-436-9747
Practice Address - Street 1:11321 ABOITE CENTER RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46814-5472
Practice Address - Country:US
Practice Address - Phone:260-432-0970
Practice Address - Fax:260-436-9747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100288330Medicaid
590010043OtherRRMC
590010043OtherRRMC