Provider Demographics
NPI:1598769564
Name:TOWN OF SCHERERVILLE
Entity Type:Organization
Organization Name:TOWN OF SCHERERVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUZAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-322-4581
Mailing Address - Street 1:10 E JOLIET ST
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-2011
Mailing Address - Country:US
Mailing Address - Phone:219-322-2599
Mailing Address - Fax:219-865-5506
Practice Address - Street 1:1650 CLINE AVE
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-2020
Practice Address - Country:US
Practice Address - Phone:219-322-2599
Practice Address - Fax:219-865-5506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN9854203416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN985420Medicare PIN