Organization Active NPI

Southern Ripley County Emergency Life Squad Inc

Doing business as Rescue 69

  • Ambulance
  • Versailles, IN
National Provider Identifier
1831100106
Registry record updated Nov 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
SOUTHERN RIPLEY COUNTY EMERGENCY LIFE SQUAD INC
Doing business as
Rescue 69
Practice address
727 W Hopewell Rd
Versailles, IN 47042-7324
Phone
(812) 689-3179
Fax
(812) 689-4521
NPI assigned
Aug 11, 2006
Last updated
Nov 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2018

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

Authorized official

Name
Charles Cozart
Title
Chief
Phone
(812) 689-5897

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X NU Primary

Addresses

Primary practice location

727 W Hopewell Rd
Versailles, IN 47042-7324

Mailing address

10361 Spartan Dr
Cincinnati, OH 45215-1220
Phone (800) 962-1484

Other identifiers 3

IdentifierTypeStateIssuer
P00241206OtherRAILROAD MEDICARE
2000000191167OtherINANTHEM
100289790AMedicaidIN

Other names 1

  • Rescue 69 Doing business as

National Provider Directory

National Provider Directory

Locations

727 W Hopewell Rd
#69
Versailles, IN 47042
Phone (812) 689-5897

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543190400000",
    "number": "1831100106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10361 SPARTAN DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452151220",
            "telephone_number": "800-962-1484",
            "fax_number": "513-772-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 W HOPEWELL RD",
            "city": "VERSAILLES",
            "state": "IN",
            "postal_code": "470427324",
            "telephone_number": "812-689-3179",
            "fax_number": "812-689-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN RIPLEY COUNTY EMERGENCY LIFE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2018-11-26",
        "status": "A",
        "authorized_official_last_name": "COZART",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "812-689-5897"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00241206",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "2000000191167",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100289790A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rescue 69",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rescue 69",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Versailles, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.