TIPPECANOE EMERGENCY AMBULANCE SERVICE NPI 1063497121

NPI Information

NPI: 1063497121
Provider Name: TIPPECANOE EMERGENCY AMBULANCE SERVICE

Doing Business As: TEAS

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
1501 HARTFORD ST
LAFAYETTE, IN
ZIP 47904
Phone: (765) 423-6235
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TIPPECANOE EMERGENCY AMBULANCE SERVICE is a land transport ambulance in Lafayette, IN. TIPPECANOE EMERGENCY AMBULANCE SERVICE NPI is 1063497121. The provider is registered as an organization entity type.
The provider Is Doing Business As Teas.

The provider's business location address is:

1501 HARTFORD ST
LAFAYETTE, IN
ZIP 47904-134
Phone: (765) 423-6235
Fax: (765) 423-6049

The provider's authorized official is Allen L. Borck .
The authorized official title is Ceo and has the following contact phone number (765) 423-6235.

The CLIA number assigned to this NPI record is 15D2235324 - other - work release center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/13/2005 and was last updated on 5/29/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	0007	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	978810	MEDICARE PIN	INDIANA
2	000000197897	OTHER	INDIANA	ANTHEM
3	791590342	OTHER		RR MEDICARE
4	978820	MEDICARE ID-TYPE UNSPECIFIED	INDIANA
5	100281800	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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