Organization
NORTHWEST AMBULANCE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASIL NNAMDY UBANWA PHD (PRESIDIENT)
(219) 756-6607
Entity
Organization
Contact information
Practice address
100 W 79TH AVE, MERRILLVILLE, IN 46410-5439
(219) 756-6667
Mailing address
100 W 79TH AVE, MERRILLVILLE, IN 46410-5439
(219) 756-6667
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
PENDING
IN
3416L0300X
Land Ambulance
PENDING (NEW APP)
IN
343900000X
Non-emergency Medical Transport (VAN)
PENDING (NEW APP)
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING (NEW APPL)
—
IN
Enumeration date
09/06/2007
Last updated
10/16/2017
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