Provider Demographics
NPI:1770686842
Name:CITY OF WABASH
Entity Type:Organization
Organization Name:CITY OF WABASH
Other - Org Name:WABASH CITY COUNTY AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CAC, CACO, CADS
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCHENKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-569-9274
Mailing Address - Street 1:202 S WABASH ST
Mailing Address - Street 2:
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992
Mailing Address - Country:US
Mailing Address - Phone:260-563-4171
Mailing Address - Fax:260-563-0876
Practice Address - Street 1:202 S WABASH ST
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992
Practice Address - Country:US
Practice Address - Phone:260-563-4171
Practice Address - Fax:260-563-0876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100281980AMedicaid