Provider Demographics
NPI:1124071188
Name:LA PORTE COUNTY AUDITOR
Entity type:Organization
Organization Name:LA PORTE COUNTY AUDITOR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-326-6808
Mailing Address - Street 1:809 STATE ST
Mailing Address - Street 2:SUITE 301A
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-3390
Mailing Address - Country:US
Mailing Address - Phone:219-326-6808
Mailing Address - Fax:219-872-0117
Practice Address - Street 1:809 STATE ST
Practice Address - Street 2:SUITE 301A
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-3391
Practice Address - Country:US
Practice Address - Phone:219-326-6808
Practice Address - Fax:219-872-0117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN4601463416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000186127OtherBLUE CROSS BLUE SHIELD
IN100281460AMedicaid
GA590164306OtherRAILROAD MEDICARE
IN000000186127OtherBLUE CROSS BLUE SHIELD