Organization
SELLERSBURG VOLUNTEER FIRE DEPARTMENT, INC.
Active
Other names
CLARK COUNTY EMS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK BALL (DIRECTOR)
(812) 245-6655
Entity
Organization
Contact information
Practice address
426 E UTICA ST, SELLERSBURG, IN 47172-1405
(812) 246-6655
(812) 246-7241
Mailing address
PO BOX 589, MADISONVILLE, KY 42431-5011
(270) 824-8123
(270) 824-8140
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0420
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000066545
ANTHEM BLUE CROSS
KY
05
—
100290730A
—
IN
01
—
129917300
FEDERAL BLACK LUNG PROGRAM
—
05
—
55340624
—
KY
05
—
56008006
—
KY
01
—
N285210
HARMONY HEALTH PLAN
IN
Enumeration date
07/04/2005
Last updated
10/17/2011
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