Provider Demographics
NPI:1417955873
Name:BOARD OF COMMISSIONERS OF NEWTON COUNTY
Entity type:Organization
Organization Name:BOARD OF COMMISSIONERS OF NEWTON COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KALIZAE
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:888-663-9866
Mailing Address - Street 1:9951 N 100 E
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46349-9317
Mailing Address - Country:US
Mailing Address - Phone:888-663-9866
Mailing Address - Fax:219-345-2064
Practice Address - Street 1:9951 N 100 E
Practice Address - Street 2:
Practice Address - City:LAKE VILLAGE
Practice Address - State:IN
Practice Address - Zip Code:46349-9317
Practice Address - Country:US
Practice Address - Phone:888-663-9866
Practice Address - Fax:219-345-2064
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOARD OF COMMISSIONERS OF NEWTON COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-11
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02513416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1417955873OtherGROUP ADMINISTRATORS LTD
IN590009787OtherUNITED HEALTH
IN100287780AMedicaid
KY000000189146OtherANTHEM
IN100287780Medicaid
KS1417955873OtherCONTINENTAL GEN INS CO IN
IN17148OtherARNETT HMO
IN000000189146OtherBC/BS
MIP62949OtherBLUE CARE
MIP62949OtherBLUE CARE