1578679437 NPI number — CITY OF CROWN POINT

Table of content: (NPI 1578679437)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578679437 NPI number — CITY OF CROWN POINT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF CROWN POINT
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:
CROWN POINT FIRE RESCUE
Provider Other Organization Name Type Code:
5
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:
1578679437
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 N EAST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CROWN POINT
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46307-4027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-488-2374
Provider Business Mailing Address Fax Number:
219-662-3378

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
126 N EAST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CROWN POINT
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46307-4028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-488-2374
Provider Business Practice Location Address Fax Number:
219-323-8606
Provider Enumeration Date:
08/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BAUMGARDNER
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
219-662-3248

Provider Taxonomy Codes

  • Taxonomy code: 146L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000198776 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 136569 . This is a "IN DEPT HLTH" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 791590701 . This is a "RR PALMETTO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 05121922950 . This is a "CARE SOURCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100287060A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 015896 . This is a "CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 703362 . This is a "MANAGED HEALTH" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com