Organization
TOWN OF WOLCOTT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE YOUNG (DIRECTOR)
(219) 279-9255
Entity
Organization
Contact information
Practice address
116 S. RANGE ST., WOLCOTT, IN 47995
(219) 279-2558
Mailing address
PO BOX 38, WOLCOTT, IN 47995-0038
(219) 279-2216
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0270
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000208908
ANTHEM
IN
05
—
100281820A
—
IN
01
—
791590451
RAILROAD MEDICARE
—
Enumeration date
08/05/2006
Last updated
04/23/2019
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