# MONROE HOSPITAL AMBULANCE SERVICE

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

## Provider details

- **NPI number:** 1801046347
- **Authorized official:** DR. JONATHAN D HART MD (CEO/MEDICAL DIRECTOR)
- **Authorized official phone:** (812) 825-0892

## Contact information

- **Practice address:** 4011 S MONROE MEDICAL PARK BLVD, BLOOMINGTON, IN 47403-8000
- **Practice address phone:** (812) 825-0904
- **Mailing address:** 4011 S MONROE MEDICAL PARK BLVD, BLOOMINGTON, IN 47403-8000
- **Mailing address phone:** (812) 825-0904

## Taxonomy

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

## Other

- **Enumeration date:** 09/21/2008
- **Last updated:** 01/23/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200921860A | — | IN |
| 01 | — | 258790 | MEDICARE PTAN | IN |