Provider Demographics
NPI:1518978899
Name:AURORA EMERGENCY RESCUE, INC.
Entity Type:Organization
Organization Name:AURORA EMERGENCY RESCUE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:OPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-926-1865
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46515-0727
Mailing Address - Country:US
Mailing Address - Phone:574-293-3030
Mailing Address - Fax:574-294-1345
Practice Address - Street 1:320 3RD ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IN
Practice Address - Zip Code:47001
Practice Address - Country:US
Practice Address - Phone:812-926-1865
Practice Address - Fax:812-926-3150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN03123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000334818OtherANTHEM
IN200169040AMedicaid
P00171651OtherRRMC PTAN
IN200169040AMedicaid