Organization
CARLISLE LIONS COMMUNITY AMBULANCE INC
Active
Organization
CARLISLE LIONS COMMUNITY AMBULANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ANN DUDLEY 7731397 INTERMEDIATE (CHIEF EXECUTIVE OFFICER)
(812) 398-4693
Entity
Organization
Contact information
Practice address
2549 E COUNTY ROAD 700 S, CARLISLE, IN 47838-8245
(812) 398-4046
(812) 398-9094
Mailing address
3134 MALLARD COVE LN, FORT WAYNE, IN 46804-2882
(260) 436-9495
(260) 436-7235
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0024
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000202117
ANTHEM
IN
05
—
100281640A
—
IN
Enumeration date
08/04/2006
Last updated
07/24/2013
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