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Organization

LADOGA RESCUE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL HUNLEY (DIRECTOR)
(765) 942-2580
Entity
Organization

Contact information

Practice address
1025 E. MAIN ST., LADOGA, IN 47954-9999
(765) 942-2580
Mailing address
PO BOX 266, LADOGA, IN 47954-0266
(765) 942-2580

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0499
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000318682
ANTHEM
IN
05
200161580A
IN
Enumeration date
07/27/2006
Last updated
03/17/2018
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