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Organization

THREE RIVERS AMBULANCE AUTHORITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOEL BENZ (EXECUTIVE DIRECTOR)
(260) 420-6500
Entity
Organization

Contact information

Practice address
525 HAYDEN ST, FORT WAYNE, IN 46802-3550
(260) 420-6500
Mailing address
PO BOX 11724, 525 HAYDEN ST, FORT WAYNE, IN 46860-1724
(260) 420-6500

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0114
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0114
STATE EMS PROVIDER CERT
IN
05
100288230A
IN
Enumeration date
07/01/2005
Last updated
03/01/2024
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