Organization
PORTAGE TOWNSHIP PORTER COUNTY
Active
Other names
Portage Township Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA CLANCY (TRUSTEE)
(219) 762-1623
Entity
Organization
Contact information
Practice address
398 W 700 N, VALPARAISO, IN 46385
(219) 759-3919
(219) 759-8068
Mailing address
PO BOX 429, LEWISVILLE, NC 27023-0429
(734) 224-4474
(336) 791-0196
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0067
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210160
ANTHEM
IN
05
—
100288610
—
IN
Enumeration date
05/16/2006
Last updated
08/04/2025
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