Provider Demographics
NPI:1528097409
Name:NORTHEAST ALLEN COUNTY FIRE & EMS, INC.
Entity type:Organization
Organization Name:NORTHEAST ALLEN COUNTY FIRE & EMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:YODER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-627-5133
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:GRABILL
Mailing Address - State:IN
Mailing Address - Zip Code:46741-0428
Mailing Address - Country:US
Mailing Address - Phone:260-627-5133
Mailing Address - Fax:260-627-8953
Practice Address - Street 1:13415 STATE STREET
Practice Address - Street 2:
Practice Address - City:GRABILL
Practice Address - State:IN
Practice Address - Zip Code:46741-0428
Practice Address - Country:US
Practice Address - Phone:260-627-5133
Practice Address - Fax:260-627-8953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08973416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100281150Medicaid
IN251860Medicare PIN