Organization
SCOTT COUNTY
Active
Other names
Scott County EMS
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB CARROLL (EMS DIRECTOR)
(812) 754-0500
Entity
Organization
Contact information
Practice address
1468 SCOTT VALLEY DR, SCOTTSBURG, IN 47170-7795
(812) 754-0500
(812) 754-0501
Mailing address
PO BOX 727, ELKHART, IN 46515-0727
(574) 293-3030
(574) 294-1345
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0898
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000363633
ANTHEM
IN
05
—
200513620A
—
IN
01
—
P00345462
RRMC PTAN
—
Enumeration date
09/20/2006
Last updated
04/21/2017
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