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Organization

TOWN OF MERRILLVILLE EMS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ROSE ANN ANTICH (TOWN OF MERRILLVILLE CLERK-TREASURE)
(219) 769-3699
Entity
Organization

Contact information

Practice address
26 W 73RD AVE, MERRILLVILLE, IN 46410-3802
(219) 769-0400
Mailing address
7820 BROADWAY, MERRILLVILLE, IN 46410-5557
(219) 769-3699

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0333
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000191002
BLUE CROSS BLUE SHIELD
IN
Enumeration date
03/13/2007
Last updated
08/22/2020
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