Organization
CARPENTER TOWNSHIP TTEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA HAWKES (TRUSTEE)
(219) 261-2374
Entity
Organization
Contact information
Practice address
33 N. INDIANA STREET, REMINGTON, IN 47977
(219) 261-2374
Mailing address
705 N NEBRASKA ST, REMINGTON, IN 47977-8676
(219) 261-2374
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0228
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000207716
ANTHEM
IN
05
—
100282110
—
IN
01
—
590011495
RAILROAD MEDICARE
—
Enumeration date
08/05/2006
Last updated
03/17/2018
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