# SOUTHWEST DISTRICK AMBULANCE SERVICE INC

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

## Provider details

- **NPI number:** 1881693224
- **Authorized official:** BEN MADISON (EXECUTIVE SECRETARY)
- **Authorized official phone:** (317) 775-6753

## Contact information

- **Practice address:** 7984 W US HIGHWAY 40, KNIGHTSTOWN, IN 46148-9411
- **Practice address phone:** (765) 345-9712
- **Practice address fax:** (765) 345-9713
- **Mailing address:** PO BOX 56002, INDIANAPOLIS, IN 46256-0002
- **Mailing address phone:** (317) 849-6628
- **Mailing address fax:** (317) 849-6632

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 0341 | IN | Yes |

## Other

- **Enumeration date:** 07/19/2005
- **Last updated:** 02/11/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000180914 | ANTHEM | KY |
| 05 | — | 200122950A | — | IN |
| 01 | — | 590011862 | RAILROAD MEDICARE | IN |