Provider Demographics
NPI:1801911094
Name:LIZTON UNION TOWNSHIP HENDRICKS COUNTY INDIANA VOLUNTEER FIRE DEPT
Entity type:Organization
Organization Name:LIZTON UNION TOWNSHIP HENDRICKS COUNTY INDIANA VOLUNTEER FIRE DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-775-6753
Mailing Address - Street 1:PO BOX 502250
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-7250
Mailing Address - Country:US
Mailing Address - Phone:317-849-6628
Mailing Address - Fax:317-849-6632
Practice Address - Street 1:101 E. MAIN ST.
Practice Address - Street 2:
Practice Address - City:LIZTON
Practice Address - State:IN
Practice Address - Zip Code:46149
Practice Address - Country:US
Practice Address - Phone:317-994-5400
Practice Address - Fax:317-994-5761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3416LO300X3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1542121OtherMEDICARE
IN000000229184OtherANTHEM BLUE CROSS
IN1542121OtherMEDICARE