1841330362 NPI number — EATON EMERGENCY MEDICAL TECHNICIANS INC

Table of content: (NPI 1841330362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841330362 NPI number — EATON EMERGENCY MEDICAL TECHNICIANS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EATON EMERGENCY MEDICAL TECHNICIANS INC
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:
EATON EMTS, INC.
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:
1841330362
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 W INDIANA AVE
Provider Second Line Business Mailing Address:
PO BOX 414
Provider Business Mailing Address City Name:
EATON
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47338-8832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-396-3748
Provider Business Mailing Address Fax Number:
765-396-4427

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 W INDIANA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EATON
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47338-8832
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-396-3748
Provider Business Practice Location Address Fax Number:
765-396-4427
Provider Enumeration Date:
02/07/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
WENDY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
765-399-1601

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0289 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 343900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000000242407 . This is a "ANTHEM BLUE CROSS & BLUE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 100101960A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590013960 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".