Randall J Cammenga
Emergency Medical Services
600 East Blvd
Elkhart
, Indiana 46514-2483
Randall J Cammenga
Emergency Medical Services
600 East Blvd
Elkhart
, Indiana 46514-2483
(574) 273-1137
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About
Features
Specialties
- Emergency Medical Services
Languages spoken
- English
Location
First Address
- Randall J Cammenga
- 3371 Cleveland Road Ext Suite 210
- South Bend, IN
- Zip : 46628-9780
- Fax : (574) 273-1137
- Phone : (574) 271-2558
Second Address
- Randall J Cammenga
- 600 East Blvd
- Elkhart, IN
- Zip : 46514-2483
- Fax : (574) 523-3221
- Phone : (574) 523-3161
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PE0004X | Emergency Medical Services | 01041177 | IN |
National Provider Identifier
| NPI | 1154321107 |
|---|---|
| Provider Name | Randall J Cammenga |
| First Address | South Bend, IN 46628-9780 |
| Second Address | Elkhart, IN 46514-2483 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/07/2005 |
| Last Update Date | 20/03/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000082225 | AANTHEM (01) | IN |
| F40631 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.