Provider Demographics
NPI:1265628374
Name:ADAMS TOWNSHIP OF MADISON COUNTY
Entity Type:Organization
Organization Name:ADAMS TOWNSHIP OF MADISON COUNTY
Other - Org Name:ADAMS MARKLEVILLE FIRE PROTECTION TERRITORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:LINDA D
Authorized Official - Middle Name:D
Authorized Official - Last Name:GUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-533-4373
Mailing Address - Street 1:7457 S 200 E
Mailing Address - Street 2:
Mailing Address - City:MARKLEVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46056-9650
Mailing Address - Country:US
Mailing Address - Phone:765-533-2240
Mailing Address - Fax:765-533-4471
Practice Address - Street 1:7457 S 200 EAST
Practice Address - Street 2:
Practice Address - City:MARKELVILLE
Practice Address - State:IN
Practice Address - Zip Code:46056-9650
Practice Address - Country:US
Practice Address - Phone:765-533-2240
Practice Address - Fax:765-533-4471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200455680AMedicaid
IN219770Medicare PIN