Organization
CRAWFORD COUNTY AUDITOR
Active
Other names
Crawford County Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN O GOTT PARAMEDIC (DIRECTOR)
(812) 338-2463
Entity
Organization
Contact information
Practice address
713 EAST STATE ROAD 64, ENGLISH, IN 47118-0336
(812) 338-2463
(812) 338-2463
Mailing address
PO BOX 336, ENGLISH, IN 47118-0336
(812) 338-2463
(812) 338-2463
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0180
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000176312
ANTHEM BC/BS
IN
05
—
100281700A
—
IN
01
—
5001404
PASSPORT - MA MCO
IN
01
—
590587033
RAILROAD MEDICARE - PALMETTO
IN
01
—
616211800
FEDERAL BLACK LUNG PROGRAM
IN
Enumeration date
09/13/2005
Last updated
03/12/2013
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