Organization
CICERO TOWNSHIP VOLUNTEER FIRE DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J. PRATT (CHIEF)
(765) 675-8004
Entity
Organization
Contact information
Practice address
750 DEVELOPMENT DR, TIPTON, IN 46072-1072
(765) 675-8004
(765) 675-3528
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
0083
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000333620
ANTHEM
IN
05
—
200473580A
—
IN
01
—
P00399940
RRMC PTAN
—
Enumeration date
08/11/2006
Last updated
06/17/2008
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