Provider Demographics
NPI:1295790509
Name:ABLE AMBULANCE, INC
Entity type:Organization
Organization Name:ABLE AMBULANCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-664-9011
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-0386
Mailing Address - Country:US
Mailing Address - Phone:765-664-9011
Mailing Address - Fax:765-668-0378
Practice Address - Street 1:700 E 3RD ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952
Practice Address - Country:US
Practice Address - Phone:765-664-9011
Practice Address - Fax:765-668-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100281350Medicaid
IN100281350Medicaid