Northern Edgar County Amb Ser

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

653301 Issued in IL

Legal business name

NORTHERN EDGAR COUNTY AMB SER

Practice address

110 S Iowa
Chrisman, IL 61924-0144

Phone

(217) 269-3022

Fax

(217) 269-2348

NPI assigned

Feb 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Laura M Fletcher

Title

Secretary Tresurer

Phone

(217) 269-3022

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003941139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S IOWA",
            "address_2": "PO BOX 144",
            "city": "CHRISMAN",
            "state": "IL",
            "postal_code": "619240144",
            "telephone_number": "217-269-3022",
            "fax_number": "217-269-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S IOWA",
            "city": "CHRISMAN",
            "state": "IL",
            "postal_code": "619240144",
            "telephone_number": "217-269-3022",
            "fax_number": "217-269-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN EDGAR COUNTY AMB SER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SECRETARY TRESURER",
        "authorized_official_telephone_number": "217-269-3022"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "653301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2332001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Chrisman, IL
• Providers in Chrisman, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.