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Organization

FOUR- WAY AMBULANCE EMERGENCY SERVICE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARSHA A SCOTT (SEC TREAS)
(574) 353-7460
Entity
Organization

Contact information

Practice address
201 W MAIN, MENTONE, IN 46539
(574) 353-7460
(574) 353-7807
Mailing address
BOX 225, MENTONE, IN 46539
(574) 353-7460
(574) 353-7807

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0242
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000234647
ANTHEM
IN
05
100281950A
IN
Enumeration date
01/22/2007
Last updated
12/19/2022
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