Vernon TWP Trustee
Organization Active NPI Ambulance · Fortville, IN
NPI 1811530462 · NPPES record last updated Oct 5, 2020
Key facts
- NPI
- 1811530462
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- Legal business name
- VERNON TWP TRUSTEE
- Practice address
- 600 Vitality Dr
Fortville, IN 46040-1273 - Phone
- (317) 485-7327
- NPI assigned
- Oct 25, 2019
- Organization subpart
- No
Authorized official
- Name
- Kiely Culberson
- Title
- EMS Chief
- Phone
- (317) 775-6753
Practitioners 1
-
Kiely D Rednour, PTA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191218000486 | IN | Part B Supplier - Ambulance Service Supplier | 4981038304 | Practice locations: Fortville, IN |
National Provider Directory
Locations
602 Vitality Dr
Ste A
Fortville, IN 46040
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Yes |
Addresses
Primary practice location
600 Vitality Dr
Fortville, IN 46040-1273
Mailing address
PO Box 56002
Indianapolis, IN 46256-0002
Phone (317) 775-6753
Other names
- VERNON TOWNSHIP FIRE DEPARTMENT
Other providers in Fortville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2020. 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.