Organization
GREENTOWN VOLUNTEER FIRE COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE J SHROCK (TRES)
(765) 438-6277
Entity
Organization
Contact information
Practice address
224 N MERIDIAN ST, GREENTOWN, IN 46936
(765) 628-7750
Mailing address
PO BOX 335, GREENTOWN, IN 46936-0335
(765) 628-7750
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0008
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000365508
ANTHEM
IN
05
—
200906690A
—
IN
Enumeration date
02/08/2007
Last updated
05/18/2018
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