# FOUR- WAY AMBULANCE EMERGENCY SERVICE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083768667
- **Authorized official:** MRS. MARSHA A SCOTT (SEC TREAS)
- **Authorized official phone:** (574) 353-7460

## Contact information

- **Practice address:** 201 W MAIN, MENTONE, IN 46539
- **Practice address phone:** (574) 353-7460
- **Practice address fax:** (574) 353-7807
- **Mailing address:** BOX 225, MENTONE, IN 46539
- **Mailing address phone:** (574) 353-7460
- **Mailing address fax:** (574) 353-7807

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 0242 | IN | Yes |

## Other

- **Enumeration date:** 01/22/2007
- **Last updated:** 12/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000234647 | ANTHEM | IN |
| 05 | — | 100281950A | — | IN |