CIVIL CITY OF LAKE STATION IND (NPI# 1336214493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336214493 |
| Entity Type | Organization |
| Organization Name | CIVIL CITY OF LAKE STATION IND |
| Other Organization Name | CITY OF LAKE STATION |
| Practice Address |
1876 Fairview Ave Lake Station IN 46405 |
| Mailing Address |
1969 Central Ave Lake Station IN 46405-2059 |
| Practice Telephone | 2199628295 |
| Mailing Telephone | 2199622081 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2018-12-05 |
| Authorized Official Name | CHARLES FAZEKAS (FIRE CHIEF) |
| Authorized Official Telephone | 2199456629 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
0291 | IN | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 000000215119 | 01 |
| IN | 200262890A | 05 |
| Other Name | Type Code |
|---|---|
| City of Lake Station | Doing Business As Name - Organization |
| Lake Station Ambulance | Doing Business As Name - Organization |
| Street Address |
1876 FAIRVIEW AVE |
| City | LAKE STATION |
| State | IN |
| Zip Code | 46405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245507748 | Melissa Goldsberry | Pharmacist | 9500 Central Avenue, Lake Station, IN 46405 | 2011-11-28 |
| 1518085992 | Nikki A Wargo Dds | Dentist | 2370 E 37th Ave, Lake Station, IN 46405 | 2007-03-26 |
| 1720511785 | Patience Tieri | Nurse Practitioner | 2490 Central Ave, Lake Station, IN 46405 | 2017-04-06 |
| 1982041893 | Nanette Lindesmith | Nurse Practitioner | 3304 Parkside Ave, Lake Station, IN 46405 | 2013-05-31 |
| 1639249212 | Maria Rosario Badar | Internal Medicine | 3820 Central Ave, Lake Station, IN 46405 | 2006-11-09 |
| 1972895647 | Northshore Health Centers, Inc. | Family Medicine | 3304 Parkside Ave, Lake Station, IN 46405-1143 | 2011-05-12 |
| 1215289186 | Kari Payton | Specialist/Technologist | 3304 Parkside Ave, Lake Station, IN 46405-1143 | 2012-10-02 |
| 1972637171 | Southlake Tricity Rba | Custodial Care Facility | 2075 Ripley St, Lake Station, IN 46405-1161 | 2007-03-16 |
| 1699043190 | Jennifer Marie Legg | Licensed Practical Nurse | 2075 Ripley St, Lake Station, IN 46405-1161 | 2011-12-12 |
| 1689994683 | Charlene Jackson | Licensed Practical Nurse | 2075 Ripley St, Lake Station, IN 46405-1161 | 2010-06-02 |
| Find all providers in zip 46405 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922648781 | Center-jackson Township Fire Territory Corporation | Ambulance | 11216 E State Road 54, Bloomfield, IN 47424-6073 | 2020-01-09 |
| 1518503721 | Olive Township St Joseph County | Ambulance | 204 E. Michigan, New Carlisle, IN 46552 | 2019-11-22 |
| 1871146365 | City of Muncie | Ambulance | 300 N High St, Muncie, IN 47305-1639 | 2019-07-23 |
| 1063987824 | Norwood Enterprises, LLC | Ambulance | 1256 E 86th Pl, Merrillville, IN 46410-6338 | 2018-10-09 |
| 1619472081 | Stoney Creek Township Madison County | Ambulance | 8871 W 200 S, Lapel, IN 46051-9712 | 2018-03-28 |
| 1710492939 | Phoenix Paramedic Solutions, LLC | Ambulance | 1600 Kepner Dr Ste E, Lafayette, IN 47905-7436 | 2017-12-11 |
| 1174035570 | Blue Angel Ems, LLC | Ambulance | 8250 E 95th Pl, Crown Point, IN 46307-9464 | 2017-10-26 |
| 1275050023 | City of Logansport | Ambulance | 630 High St, Logansport, IN 46947-2767 | 2017-08-23 |
| 1689191462 | West Point Volunteer Fire Association, Inc | Ambulance | 4949 St. Rd. 25 South, West Point, IN 47992-0071 | 2017-08-23 |
| 1861918849 | Corey Simmons | Ambulance | 3659 N Temple Ave, Indianapolis, IN 46218 | 2017-08-21 |
| Find all providers with the same taxonomy | ||||
| City | LAKE STATION |
| Zip Code | 46405 |
Please comment or provide details below to improve the information on CIVIL CITY OF LAKE STATION IND.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.