Organization
SUNMAN AREA LIFE SQUAD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MAYNARD (CHIEF OF EMS)
(812) 623-2763
Entity
Organization
Contact information
Practice address
403 N MERIDIAN ST, SUNMAN, IN 47041
(812) 623-2763
(812) 623-5100
Mailing address
PO BOX 392907, PITTSBURGH, PA 15251-9907
(574) 293-3030
(574) 294-1345
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0004
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000303775
ANTHEM
IN
05
—
200297690A
—
IN
01
—
P00164852
RRMC
IN
Enumeration date
09/26/2006
Last updated
05/17/2024
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