Organization
MILAN RESCUE 30 INC.
Active
Organization
MILAN RESCUE 30 INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON NICHOLS (BOARD PRESIDENT)
(812) 654-2842
Entity
Organization
Contact information
Practice address
212 MAPLE STREET, MILAN, IN 47031
(812) 654-2848
Mailing address
PO BOX 2915, ELKHART, IN 46515-2915
(574) 293-3030
(574) 294-1345
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0403
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000303793
ANTHEM
IN
05
—
100182320A
—
IN
01
—
P00164855
RRMC PTAN
—
Enumeration date
08/30/2006
Last updated
06/17/2008
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