Provider Demographics
NPI:1225141724
Name:HENRY COUNTY AUDITOR
Entity Type:Organization
Organization Name:HENRY COUNTY AUDITOR
Other - Org Name:HENRY COUNTY EMS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:EMTA,PI,CADS
Authorized Official - Phone:765-545-0330
Mailing Address - Street 1:127 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:47362-4524
Mailing Address - Country:US
Mailing Address - Phone:765-545-0330
Mailing Address - Fax:574-294-1354
Practice Address - Street 1:127 N 12TH ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:IN
Practice Address - Zip Code:47362-4524
Practice Address - Country:US
Practice Address - Phone:765-545-0330
Practice Address - Fax:657-545-4826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08343416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000298001OtherANTHEM
IN200442490AMedicaid
IN207770OtherMEDICARE
P00050231OtherRRMC PTAN