SUPERIOR AIR-GROUND AMBULANCE SERVICE OF INDIANA INC NPI 1952683229

NPI Information

NPI: 1952683229
Provider Name: SUPERIOR AIR-GROUND AMBULANCE SERVICE OF INDIANA, INC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 14D2199367

Address:
2605 GARFIELD AVE
HIGHLAND, IN
ZIP 46322
Phone: (830) 832-2000
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SUPERIOR AIR-GROUND AMBULANCE SERVICE OF INDIANA, INC is a land transport ambulance in Highland, IN. SUPERIOR AIR-GROUND AMBULANCE SERVICE OF INDIANA, INC NPI is 1952683229. The provider is registered as an organization entity type.

The provider's business location address is:

2605 GARFIELD AVE
HIGHLAND, IN
ZIP 46322-609
Phone: (830) 832-2000

The provider's authorized official is Kimberly Pate Godden .
The authorized official title is Corporate Secretary and has the following contact phone number (630) 832-2000.

The CLIA number assigned to this NPI record is 14D2199367 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/13/2011 and was last updated on 2/20/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416A0800X	Ambulance	Air Transport	0650	INDIANA	No
2	343900000X	Non-emergency Medical Transport (VAN)		0650	INDIANA	No
3	3416L0300X	Ambulance	Land Transport	0650	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	IN1251	MEDICARE PIN
2	2012654050A	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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