Provider Demographics
NPI:1861730111
Name:MADISON COUNTY EMERGENCY SERVICES PC
Entity type:Organization
Organization Name:MADISON COUNTY EMERGENCY SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:PINEGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-646-8439
Mailing Address - Street 1:908 N OAKDEN RD
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-3331
Mailing Address - Country:US
Mailing Address - Phone:765-646-8439
Mailing Address - Fax:765-646-8578
Practice Address - Street 1:2015 JACKSON ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-4337
Practice Address - Country:US
Practice Address - Phone:765-646-8439
Practice Address - Fax:765-646-8578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty