Organization
LA PORTE COUNTY AUDITOR
Active
Organization
LA PORTE COUNTY AUDITOR
Active
Other names
La Porte County Emergency Medical Service
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA L PEASE (ADMINISTRATOR)
(219) 326-6808
Entity
Organization
Contact information
Practice address
809 STATE ST, SUITE 301A, LA PORTE, IN 46350-3391
(219) 326-6808
(219) 872-0117
Mailing address
809 STATE ST, SUITE 301A, LA PORTE, IN 46350-3390
(219) 326-6808
(219) 872-0117
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
460146
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000186127
BLUE CROSS BLUE SHIELD
IN
05
—
100281460A
—
IN
01
—
590164306
RAILROAD MEDICARE
GA
Enumeration date
05/18/2006
Last updated
06/17/2013
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