Provider Demographics
NPI:1780654160
Name:STARKE COUNTY
Entity Type:Organization
Organization Name:STARKE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-772-9140
Mailing Address - Street 1:53 E MOUND ST
Mailing Address - Street 2:P.O. BOX 353
Mailing Address - City:KNOX
Mailing Address - State:IN
Mailing Address - Zip Code:46534-1104
Mailing Address - Country:US
Mailing Address - Phone:574-772-9140
Mailing Address - Fax:574-772-9121
Practice Address - Street 1:53 E MOUND ST
Practice Address - Street 2:
Practice Address - City:KNOX
Practice Address - State:IN
Practice Address - Zip Code:46534-1104
Practice Address - Country:US
Practice Address - Phone:574-772-9140
Practice Address - Fax:574-772-9121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN00543416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100287970AMedicaid
IN000000205902OtherBLUE CROSS BLUE SHIELD
IN792590074Medicare ID - Type UnspecifiedRAILRAOD MEDICARE
IN000000205902OtherBLUE CROSS BLUE SHIELD