1982696977 NPI number — CARE AMBULANCE SERVICE LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982696977 NPI number — CARE AMBULANCE SERVICE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE AMBULANCE SERVICE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982696977
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2107
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-214-7359
Provider Business Mailing Address Fax Number:
502-214-7441

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1202 W 16TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-214-7359
Provider Business Practice Location Address Fax Number:
502-214-7441
Provider Enumeration Date:
08/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RHODES
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
Authorized Official Title or Position:
CONTROLLER
Authorized Official Telephone Number:
502-214-7359

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  0637 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000189081 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200258810 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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