Organization
MIDDLEBURY CIVIL TWP ELKHART GORDON NUSBAUM TTEE
Active
Organization
MIDDLEBURY CIVIL TWP ELKHART GORDON NUSBAUM TTEE
Active
Other names
MIDDLEBURY CIVIL TWP
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA MUELLER (EMS ADMINISTRATOR)
(574) 825-3446
Entity
Organization
Contact information
Practice address
117 N MAIN ST, MIDDLEBURY, IN 46540-9085
(574) 825-3446
(574) 825-3118
Mailing address
PO BOX 429, LEWISVILLE, NC 27023-0429
(336) 791-0196
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0056
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000229151
ANTHEM BCBS
IN
05
—
100286840A
—
IN
Enumeration date
06/11/2006
Last updated
08/18/2026
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