Provider Demographics
NPI:1225095078
Name:CRAWFORDSVILLE EMERGENCY AMBULANCE SERVICE
Entity Type:Organization
Organization Name:CRAWFORDSVILLE EMERGENCY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KADINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-362-1277
Mailing Address - Street 1:100 S WATER ST
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-2533
Mailing Address - Country:US
Mailing Address - Phone:765-362-1277
Mailing Address - Fax:765-364-5187
Practice Address - Street 1:100 S WATER ST
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-2533
Practice Address - Country:US
Practice Address - Phone:765-362-1277
Practice Address - Fax:765-364-5187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN540002341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000214589OtherANTHEM BC/BS
IN100281620AMedicaid
IN000000214589OtherANTHEM BC/BS