Provider Demographics
NPI:1821723115
Name:TOWN OF PENDLETON PENDLETON CLERK TREAS
Entity Type:Organization
Organization Name:TOWN OF PENDLETON PENDLETON CLERK TREAS
Other - Org Name:SOUTH MADISON FIRE PROTECTION TERRITORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:NODINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-775-6753
Mailing Address - Street 1:PO BOX 503024
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-8024
Mailing Address - Country:US
Mailing Address - Phone:317-775-6751
Mailing Address - Fax:
Practice Address - Street 1:100 S BROADWAY STREET
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:IN
Practice Address - Zip Code:46064
Practice Address - Country:US
Practice Address - Phone:765-778-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance