Winchester EMS

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

3096 Issued in IL

Legal business name

WINCHESTER EMS

Practice address

734 State Highway 106
Winchester, IL 62694-1036

Phone

(217) 742-3467

Fax

(217) 742-3733

NPI assigned

Nov 15, 2006

Last updated

May 26, 2015By 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

Mr. Randy A Dolen

Title

President

Phone

(217) 742-3467

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1083787428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 STATE HIGHWAY 106 SOUTH",
            "address_2": "PO BOX 122",
            "city": "WINCHESTER",
            "state": "IL",
            "postal_code": "626941215",
            "telephone_number": "217-742-3467",
            "fax_number": "217-742-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 STATE HIGHWAY 106",
            "city": "WINCHESTER",
            "state": "IL",
            "postal_code": "626941036",
            "telephone_number": "217-742-3467",
            "fax_number": "217-742-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINCHESTER EMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "DOLEN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-742-3467",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "3096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.