Organization
CITY OF CONNERSVILLE
Active
Other names
Fayette County First Aid
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSEMARY BROWN (CITY CLERK TREASURER)
(765) 825-1271
Entity
Organization
Contact information
Practice address
2330 N PARK RD, CONNERSVILLE, IN 47331-2904
(765) 825-3524
Mailing address
500 N CENTRAL AVE, CONNERSVILLE, IN 47331-2046
(765) 825-6706
(765) 827-0858
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
01057220A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000315505
ANTHEM
IN
05
—
100282160A
—
IN
Enumeration date
02/09/2007
Last updated
01/30/2020
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