Provider Demographics
NPI:1992734131
Name:UNION NORTH AMBULANCE SERVICE
Entity type:Organization
Organization Name:UNION NORTH AMBULANCE SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:NRP
Authorized Official - Phone:574-952-1721
Mailing Address - Street 1:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:LAPAZ
Mailing Address - State:IN
Mailing Address - Zip Code:46537-0379
Mailing Address - Country:US
Mailing Address - Phone:800-926-6985
Mailing Address - Fax:734-479-6319
Practice Address - Street 1:411 S. MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:LA PAZ
Practice Address - State:IN
Practice Address - Zip Code:46537
Practice Address - Country:US
Practice Address - Phone:574-784-2438
Practice Address - Fax:574-784-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0061341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100281660AMedicaid
IN100281660AMedicaid