# LAKESHORE EMS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakeshore EMS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154606101
- **Authorized official:** MR. MARK R MONTOYA (OWNER)
- **Authorized official phone:** (219) 945-3607

## Contact information

- **Practice address:** 3480 E 83RD PL, MERRILLVILLE, IN 46410-6547
- **Practice address phone:** (219) 663-2896
- **Practice address fax:** (219) 794-1077
- **Mailing address:** 3480 E 83RD PL, MERRILLVILLE, IN 46410-6547
- **Mailing address phone:** (219) 663-2896
- **Mailing address fax:** (219) 794-1077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | NULL | Yes |
| 3416L0300X | Land Ambulance | — | NULL | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |

## Other

- **Enumeration date:** 10/20/2011
- **Last updated:** 05/05/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 201135230 | — | IN |