Walkerton Polk Lincoln Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0267 Issued in IN

Legal business name

WALKERTON POLK LINCOLN AMBULANCE SERVICE

Practice address

510 Roosevelt Rd
Walkerton, IN 46574-1216

Phone

(574) 586-3711

NPI assigned

Oct 31, 2007

Last updated

Oct 31, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karol Jackson

Title

President

Phone

(574) 586-3711

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1730368333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 ROOSEVELT RD",
            "city": "WALKERTON",
            "state": "IN",
            "postal_code": "465741216",
            "telephone_number": "574-586-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 ROOSEVELT RD",
            "city": "WALKERTON",
            "state": "IN",
            "postal_code": "465741216",
            "telephone_number": "574-586-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALKERTON POLK LINCOLN AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KAROL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-586-3711"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IN",
            "license": "0267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laporte Regional Physician Network (Walkerton Medical Clinic)
• Chukwunonso Nwandu, PHARMD
• Rori Peterson
• Lisa Ann Rizek
• Town of Walkerton (Walkerton Lincoln Fire Territory)
• Glenn John Wisnieski, DDS
• Benjamin P. Yourchock, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.