# CITY OF ELKHART

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

## Provider details

- **NPI number:** 1114072964
- **Authorized official:** MR. SHAUN EDGERTON (ASSISTANT CHIEF OF OPERATIONS)
- **Authorized official phone:** (574) 293-8931

## Contact information

- **Practice address:** 500 EAST ST, ELKHART, IN 46516-3610
- **Practice address phone:** (734) 253-0103
- **Practice address fax:** (574) 522-1023
- **Mailing address:** PO BOX 2122, RIVERVIEW, MI 48193-1122
- **Mailing address phone:** (800) 926-6985
- **Mailing address fax:** (336) 510-5894

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 0135 | IN | Yes |

## Other

- **Enumeration date:** 01/24/2007
- **Last updated:** 11/14/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000199574 | BLUE CROSS | IN |
| 05 | — | 200269490A | — | IN |
| 01 | — | 590014821 | RAILROAD MEDICARE | IN |