Organization
PENDLETON EMERGENCY AMBULANCE INC
Active
Other names
Indiana Non Profit Organization
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE M GASPAROVIC (TREASURER)
(317) 775-6753
Entity
Organization
Contact information
Practice address
100 S BROADWAY, PENDLETON, IN 46064
(765) 778-2400
Mailing address
PO BOX 56002, INDIANAPOLIS, IN 46256-0002
(317) 775-6753
(765) 778-7287
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
EMS COMM CERT 0041
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000187430
ANTHEM
—
05
—
100281760A
—
IN
01
—
590000389
PALMETTOGBA RR MEDICARE
—
Enumeration date
01/17/2007
Last updated
09/08/2022
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