# TOWN OF MERRILLVILLE EMS

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

## Provider details

- **NPI number:** 1780717462
- **Authorized official:** MRS. ROSE ANN ANTICH (TOWN OF MERRILLVILLE CLERK-TREASURE)
- **Authorized official phone:** (219) 769-3699

## Contact information

- **Practice address:** 26 W 73RD AVE, MERRILLVILLE, IN 46410-3802
- **Practice address phone:** (219) 769-0400
- **Mailing address:** 7820 BROADWAY, MERRILLVILLE, IN 46410-5557
- **Mailing address phone:** (219) 769-3699

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 0333 | IN | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000191002 | BLUE CROSS BLUE SHIELD | IN |