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Civil City Of Lake Station Ind
Land Ambulance in Lake Station, Indiana
NPI 1336214493

Civil City Of Lake Station Ind is a Land Ambulance based in Lake Station, IN and is specialized in Land Transport. Civil City Of Lake Station Ind practices in Lake Station, IN. The NPI Number for Civil City Of Lake Station Ind is 1336214493 and holds a License No. 0291 (Indiana).

The current practice location address for Civil City Of Lake Station Ind is 1876 Fairview Ave, Lake Station, IN and can be reached out via phone at 219-962-8295.

Location: 1876 Fairview Ave, Lake Station, IN, 46405-2059
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1336214493
Provider Name
Civil City Of Lake Station Ind
Credential
Provider Entity Type
Organization
Address
1876 Fairview Ave, Lake Station, IN, 46405-2059
Phone Number
219-962-8295
Fax Number
Provider Enumeration Date
11/22/2006
Last Update Date
06/15/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000215119 01 IN ANTHEM
200262890A 05 IN
institution
Provider Business Practice Location Address Details
Address
1876 Fairview Ave
City
Lake Station
State
Indiana
Zip
46405
Phone Number
219-962-8295
Fax Number
person
Provider Business Mailing Address Details
Address
1876 Fairview Ave
City
Lake Station
State
Indiana
Zip
46405
Phone Number
219-962-8295
Fax Number
person
Provider's Taxonomy Details 1
Type
Transportation Services
Classification
Ambulance
Speciality
Land Transport
Taxonomy
3416L0300X
License No.
0291 (Indiana)
Definition
Definition to come...
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