Provider Demographics
NPI:1417955873
Name:BOARD OF COMMISSIONERS OF NEWTON COUNTY
Entity Type:Organization
Organization Name:BOARD OF COMMISSIONERS OF NEWTON COUNTY
Other - Org Name:NEWTON COUNTY AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONYE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANWIENEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-663-9866
Mailing Address - Street 1:9951 N 100 E
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46349-9317
Mailing Address - Country:US
Mailing Address - Phone:888-663-9866
Mailing Address - Fax:219-345-2064
Practice Address - Street 1:9951 N 100 E
Practice Address - Street 2:
Practice Address - City:LAKE VILLAGE
Practice Address - State:IN
Practice Address - Zip Code:46349-9317
Practice Address - Country:US
Practice Address - Phone:888-663-9866
Practice Address - Fax:219-345-2064
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOARD OF COMMISSIONERS OF NEWTON COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-11
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02513416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP62949OtherBLUE CARE
IN17148OtherARNETT HMO
IN100287780AMedicaid
KS1417955873OtherCONTINENTAL GEN INS CO IN
IN590009787OtherUNITED HEALTH
IN000000189146OtherBC/BS
KY000000189146OtherANTHEM
IN1417955873OtherGROUP ADMINISTRATORS LTD
MIP62949OtherBLUE CARE
MIP62949OtherBLUE CARE