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Organization
CITY OF ELKHART
Active
Organization
CITY OF ELKHART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAUN EDGERTON (ASSISTANT CHIEF OF OPERATIONS)
(574) 293-8931
Entity
Organization
Contact information
Practice address
500 EAST ST, ELKHART, IN 46516-3610
(734) 253-0103
(574) 522-1023
Mailing address
PO BOX 2122, RIVERVIEW, MI 48193-1122
(800) 926-6985
(336) 510-5894
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0135
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000199574
BLUE CROSS
IN
05
—
200269490A
—
IN
01
—
590014821
RAILROAD MEDICARE
IN
Enumeration date
01/24/2007
Last updated
11/14/2025
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