Organization
GREENDALE EMERGENCY RESCUE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOMMY CRAIG (PRESIDENT)
(812) 537-1335
Entity
Organization
Contact information
Practice address
911 RIDGE AVE, GREENDALE, IN 47025-1322
(812) 537-1335
(812) 537-3850
Mailing address
911 RIDGE AVE, GREENDALE, IN 47025-1322
(812) 537-1335
(812) 537-3850
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0370
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000385477
ANTHEM
IN
05
—
200802680A
—
IN
01
—
P00399941
RRMC PTAN
—
Enumeration date
08/17/2006
Last updated
04/21/2017
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