Provider Demographics
NPI:1689809261
Name:A A TWSP VFD INC
Entity Type:Organization
Organization Name:A A TWSP VFD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEVONEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-528-2437
Mailing Address - Street 1:PO BOX 225
Mailing Address - Street 2:
Mailing Address - City:EMINENCE
Mailing Address - State:IN
Mailing Address - Zip Code:46125-0225
Mailing Address - Country:US
Mailing Address - Phone:765-528-2437
Mailing Address - Fax:765-528-2169
Practice Address - Street 1:6494 ST RD 42
Practice Address - Street 2:
Practice Address - City:EMINENCE
Practice Address - State:IN
Practice Address - Zip Code:46125-0225
Practice Address - Country:US
Practice Address - Phone:765-528-2437
Practice Address - Fax:765-528-2169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06773416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN20105444AMedicaid
IN20105444AMedicaid