Provider Demographics
NPI:1841330362
Name:EATON EMERGENCY MEDICAL TECHNICIANS INC
Entity type:Organization
Organization Name:EATON EMERGENCY MEDICAL TECHNICIANS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-775-6753
Mailing Address - Street 1:103 W INDIANA AVE
Mailing Address - Street 2:PO BOX 414
Mailing Address - City:EATON
Mailing Address - State:IN
Mailing Address - Zip Code:47338-8832
Mailing Address - Country:US
Mailing Address - Phone:765-396-3748
Mailing Address - Fax:765-396-4427
Practice Address - Street 1:103 W INDIANA AVE
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:IN
Practice Address - Zip Code:47338-8832
Practice Address - Country:US
Practice Address - Phone:765-396-3748
Practice Address - Fax:765-396-4427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
IN02893416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN590013960OtherRAILROAD MEDICARE
IN100101960AMedicaid
IN000000242407OtherANTHEM BLUE CROSS & BLUE
IN193790Medicare PIN