Provider Demographics
NPI:1790929271
Name:SUNMAN AREA LIFE SQUAD, INC
Entity Type:Organization
Organization Name:SUNMAN AREA LIFE SQUAD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:M
Authorized Official - Last Name:CORBIN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:812-934-8651
Mailing Address - Street 1:PO BOX 55
Mailing Address - Street 2:
Mailing Address - City:SUNMAN
Mailing Address - State:IN
Mailing Address - Zip Code:47041-0055
Mailing Address - Country:US
Mailing Address - Phone:812-623-2763
Mailing Address - Fax:812-623-5100
Practice Address - Street 1:403 S MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:SUNMAN
Practice Address - State:IN
Practice Address - Zip Code:47041-8489
Practice Address - Country:US
Practice Address - Phone:812-623-2763
Practice Address - Fax:812-623-5100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN00043416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport