Organization
CITY OF HAMMOND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY MICHAEL MARSACK PARAMEDIC (ASSISTANT CHIEF EMS COORDINATOR)
(219) 853-6418
Entity
Organization
Contact information
Practice address
6110 CALUMET AVE, HAMMOND, IN 46320-2525
(219) 853-6418
(219) 853-6319
Mailing address
PO BOX 2122, RIVERVIEW, MI 48193-1122
(800) 926-6985
(734) 479-6319
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0172
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000198672
BCBS ANTHEM
IN
01
—
P00172644
RAIL ROAD MEDICARE
IN
Enumeration date
06/11/2006
Last updated
04/20/2008
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