Organization
AMERICARE AMBULANCE SERVICE OF INDIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY A OTT (CEO/OWNER)
(317) 770-1100
Entity
Organization
Contact information
Practice address
8001 E 196TH ST, NOBLESVILLE, IN 46062-9091
(317) 770-1100
(317) 770-7002
Mailing address
8001 E 196TH ST, NOBLESVILLE, IN 46062-9091
(317) 770-1100
(317) 770-7002
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
2369
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201046460A
—
IN
01
—
M300045133
MEDICARE PTAN
IN
01
—
P01053097
RAILROAD MEDICARE
IN
Enumeration date
03/07/2011
Last updated
12/13/2012
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