Organization
TOWN OF SHIRLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW MARTIN EBBERT (FIRE CHIEF)
(765) 738-6590
Entity
Organization
Contact information
Practice address
212 MAIN ST., SHIRLEY, IN 47384-0057
(765) 738-6590
(765) 738-6521
Mailing address
PO BOX 57, 212 MAIN ST., SHIRLEY, IN 47384-0057
(765) 738-6590
(765) 738-6521
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000509764
BCBS
IN
Enumeration date
12/01/2006
Last updated
08/22/2020
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