Provider Demographics
NPI:1568405694
Name:TOWN OF WALKERTON
Entity Type:Organization
Organization Name:TOWN OF WALKERTON
Other - Org Name:WALKERTON LINCOLN FIRE TERRITORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AMBULANCE BILLING CLERK
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:HILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-586-3711
Mailing Address - Street 1:301 MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:WALKERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46574-1213
Mailing Address - Country:US
Mailing Address - Phone:574-586-3711
Mailing Address - Fax:574-586-2248
Practice Address - Street 1:506 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WALKERTON
Practice Address - State:IN
Practice Address - Zip Code:46574-1006
Practice Address - Country:US
Practice Address - Phone:574-586-3711
Practice Address - Fax:574-586-2248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02673416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100282290AMedicaid
IN979890Medicare PIN