Provider Demographics
NPI:1205927100
Name:MADISON TOWNSHIP
Entity type:Organization
Organization Name:MADISON TOWNSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-775-6753
Mailing Address - Street 1:PO BOX 56002
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-0002
Mailing Address - Country:US
Mailing Address - Phone:317-775-6753
Mailing Address - Fax:317-849-6632
Practice Address - Street 1:7047 E LANDERSDALE RD
Practice Address - Street 2:
Practice Address - City:CAMBY
Practice Address - State:IN
Practice Address - Zip Code:46113-8511
Practice Address - Country:US
Practice Address - Phone:317-775-6753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200508370AMedicaid
IN222520Medicare ID - Type UnspecifiedPROVIDER NUMBER