Provider Demographics
NPI:1982612750
Name:TOWNSHIP OF CONCORD
Entity Type:Organization
Organization Name:TOWNSHIP OF CONCORD
Other - Org Name:CONCORD TOWNSHIP FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TOWNSHIP TRUSTEE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-293-6889
Mailing Address - Street 1:2804 TOLEDO RD
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46516-5778
Mailing Address - Country:US
Mailing Address - Phone:574-293-6899
Mailing Address - Fax:574-294-7465
Practice Address - Street 1:23625 CR 18
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516-9193
Practice Address - Country:US
Practice Address - Phone:574-875-9644
Practice Address - Fax:574-875-7687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10473416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000384008OtherBCBS
INP00337260OtherRR MEDICARE
IN200366950AMedicaid
IN=========OtherTRICARE NORTH
INP00337260OtherRR MEDICARE
IN200366950AMedicaid