Provider Demographics
NPI:1578679437
Name:CITY OF CROWN POINT
Entity Type:Organization
Organization Name:CITY OF CROWN POINT
Other - Org Name:CROWN POINT FIRE RESCUE
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMGARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-662-3248
Mailing Address - Street 1:101 N EAST ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-4027
Mailing Address - Country:US
Mailing Address - Phone:219-488-2374
Mailing Address - Fax:219-662-3378
Practice Address - Street 1:126 N EAST ST
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-4028
Practice Address - Country:US
Practice Address - Phone:219-488-2374
Practice Address - Fax:219-323-8606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
No341600000XTransportation ServicesAmbulanceGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000198776OtherANTHEM BCBS
IN136569OtherIN DEPT HLTH
791590701OtherRR PALMETTO
05121922950OtherCARE SOURCE
IN100287060AMedicaid
015896OtherCHAMPUS
703362OtherMANAGED HEALTH
05121922950OtherCARE SOURCE
791590701OtherRR PALMETTO