Provider Demographics
NPI:1710023171
Name:CALUMET TOWNSHIP EMS
Entity Type:Organization
Organization Name:CALUMET TOWNSHIP EMS
Other - Org Name:LAKE COUNTY CALUMET TOWNSHIP TRUSTEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TRUSTEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-886-5909
Mailing Address - Street 1:35 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46402-1301
Mailing Address - Country:US
Mailing Address - Phone:219-886-5200
Mailing Address - Fax:219-886-5233
Practice Address - Street 1:1900 W 41ST AVE
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46408-2372
Practice Address - Country:US
Practice Address - Phone:219-980-3075
Practice Address - Fax:219-981-4025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN450003341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance