Grant County Auditor
Organization Active NPI Land Ambulance · Gas City, IN
NPI 1376598078 · NPPES record last updated Feb 15, 2023
Key facts
- NPI
- 1376598078
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 0332 (IN)
- Legal business name
- GRANT COUNTY AUDITOR
- Practice address
- 3921 S Garthwaite Rd
Gas City, IN 46933-1155 - Phone
- (765) 674-6592
- Fax
- (765) 674-7037
- NPI assigned
- May 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Dawn Renee Harness
- Title
- Billing Adminstrator
- Phone
- (765) 674-6592
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 2
Practitioners 1
-
James Raymond Rudolph, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111128000124 | IN | Part B Supplier - Ambulance Service Supplier | 8628162138 | Practice locations: Gas City, IN |
National Provider Directory
- Tax ID family
- Grant County Auditor
Locations
3921 S Garthwaite Rd
Gas City, IN 46933
Phone (765) 651-2411
401 S Adams St
Marion, IN 46953
Phone 76565124013112
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 0332 | IN | Yes |
Addresses
Primary practice location
3921 S Garthwaite Rd
Gas City, IN 46933-1155
Mailing address
401 S Adams St
Marion, IN 46953-2037
Phone (765) 674-6592
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000184723 | Other | IN | EMERGENCY AMBULANCE SERVI |
| 100287040 | Medicaid | IN |
Other names
- Grant County EMS
Other providers in Gas City, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.