Provider Demographics
NPI:1235152240
Name:WAYNE TOWNSHIP MARION CO OFFICE OF TRUSTEE
Entity Type:Organization
Organization Name:WAYNE TOWNSHIP MARION CO OFFICE OF TRUSTEE
Other - Org Name:WAYNE TOWNSHIP AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-619-0486
Mailing Address - Street 1:PO BOX 2122
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-1122
Mailing Address - Country:US
Mailing Address - Phone:734-224-4474
Mailing Address - Fax:734-479-6319
Practice Address - Street 1:700 N HIGH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-3700
Practice Address - Country:US
Practice Address - Phone:317-246-6244
Practice Address - Fax:317-246-6372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100288480AMedicaid
IN100288480AMedicaid