Milan Rescue 30 Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0403 Issued in IN

Legal business name

MILAN RESCUE 30 INC.

Practice address

212 Maple Street
Milan, IN 47031

Phone

(812) 654-2848

NPI assigned

Aug 30, 2006

Organization subpart

No

Name

Jon Nichols

Title

Board President

Phone

(812) 654-2842

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 17, 2008.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1508975863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2915",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465152915",
            "telephone_number": "574-293-3030",
            "fax_number": "574-294-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 MAPLE STREET",
            "city": "MILAN",
            "state": "IN",
            "postal_code": "47031",
            "telephone_number": "812-654-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILAN RESCUE 30 INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "BOARD PRESIDENT",
        "authorized_official_telephone_number": "812-654-2842"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "0403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100182320A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC PTAN",
            "identifier": "P00164855",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000303793",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emily Marie Suiter

• All providers in Milan, IN
• Land Ambulance in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.