Organization
SOUTHERN RIPLEY COUNTY EMERGENCY LIFE SQUAD INC
Active
Other names
Rescue 69
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES COZART (CHIEF)
(812) 689-5897
Entity
Organization
Contact information
Practice address
727 W HOPEWELL RD, VERSAILLES, IN 47042-7324
(812) 689-3179
(812) 689-4521
Mailing address
10361 SPARTAN DR, CINCINNATI, OH 45215-1220
(800) 962-1484
(513) 772-4464
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100289790A
—
IN
01
—
2000000191167
ANTHEM
IN
01
—
P00241206
RAILROAD MEDICARE
—
Enumeration date
08/11/2006
Last updated
11/26/2018
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