Organization
BROWN CIVIL TOWNSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HARRIS (TOWNSHIP TRUSTEE)
(317) 831-1734
Entity
Organization
Contact information
Practice address
471 N SAMUEL MOORE PKWY, MOORESVILLE, IN 46158-1333
(317) 831-1734
(317) 831-8697
Mailing address
471 N SAMUEL MOORE PKWY, MOORESVILLE, IN 46158-1333
(317) 831-1734
(317) 831-8697
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0089
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000342677
ANTHEM
IN
05
—
100288630A
—
IN
01
—
590001396
RRMC PTAN
—
Enumeration date
08/11/2006
Last updated
08/17/2018
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