Organization
SOUTHWEST DISTRICK AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN MADISON (EXECUTIVE SECRETARY)
(317) 775-6753
Entity
Organization
Contact information
Practice address
7984 W US HIGHWAY 40, KNIGHTSTOWN, IN 46148-9411
(765) 345-9712
(765) 345-9713
Mailing address
PO BOX 56002, INDIANAPOLIS, IN 46256-0002
(317) 849-6628
(317) 849-6632
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0341
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000180914
ANTHEM
KY
05
—
200122950A
—
IN
01
—
590011862
RAILROAD MEDICARE
IN
Enumeration date
07/19/2005
Last updated
02/11/2021
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