Greene County Ambulance
Organization Active NPI Ambulance · Carrollton, IL
NPI 1154497170 · NPPES record last updated Apr 22, 2024
Key facts
- NPI
- 1154497170
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 1707716 (IL)
- Legal business name
- GREENE COUNTY AMBULANCE
- Practice address
- 800 School St
Carrollton, IL 62016-1436 - Phone
- (217) 942-5554
- Fax
- (217) 942-9349
- NPI assigned
- Nov 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Stace Holland
- Title
- Ceo
- Phone
- (217) 942-6946
Member of 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240806000097 | IL | Part B Supplier - Ambulance Service Supplier | 5991242141 | Practice locations: Carrollton, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 1707716 | IL | Yes |
Addresses
Primary practice location
800 School St
Carrollton, IL 62016-1436
Mailing address
800 School St
Carrollton, IL 62016-1436
Phone (217) 942-5554
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 376000925001 | Medicaid | IL |
Other names
- Boyd Health Care Services
Other providers in Carrollton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.