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Organization
PORTAGE TOWNSHIP PORTER COUNTY
Active
Organization
PORTAGE TOWNSHIP PORTER COUNTY
Active
Other names
Portage Township Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA CLANCY (TRUSTEE)
(219) 762-1623
Entity
Organization
Contact information
Practice address
398 W 700 N, VALPARAISO, IN 46385
(219) 759-3919
(219) 759-8068
Mailing address
PO BOX 429, LEWISVILLE, NC 27023-0429
(734) 224-4474
(336) 791-0196
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0067
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210160
ANTHEM
IN
05
—
100288610
—
IN
Enumeration date
05/16/2006
Last updated
08/04/2025
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