Tippecanoe Emergency Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0007 Issued in IN

Legal business name

TIPPECANOE EMERGENCY AMBULANCE SERVICE

Practice address

1501 Hartford St
Lafayette, IN 47904-2134

Phone

(765) 423-6235

Fax

(765) 423-6049

NPI assigned

Dec 13, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Allen L. Borck

Title

Ceo

Phone

(765) 423-6235

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• TEAS Doing business as

Tax ID family

Teas2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Tippecanoe Emergency Ambulance Service

  • Land Ambulance
  • Lafayette, IN
  • NPI 1902982101
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1063497121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5477",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479035477",
            "telephone_number": "765-423-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HARTFORD ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042134",
            "telephone_number": "765-423-6235",
            "fax_number": "765-423-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIPPECANOE EMERGENCY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "BORCK",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "765-423-6235",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "0007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "791590342",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000197897",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100281800",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TEAS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William K Tilt, MD
• Amy Renee Timmons, RN
• Timothy J Pirnat MD Inc
• Arielle Rebecca Tingle, MS, LMHCA, NCC
• Tippecanoe County Auditor
• Tippecanoe Emergency Ambulance Service
• Tippecanoe School Corporation
• Tippecanoe Speech Language Pathology
• Amir Tirmizi, MD
• Ashlie M Tislow

• Land Ambulance in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Land Ambulance in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.