Blue Angels EMS Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

9999 Issued in IL

Legal business name

BLUE ANGELS EMS INC

Practice address

402 N Poplar St
Centralia, IL 62801-2965

Phone

(618) 532-7777

Fax

(618) 532-7722

NPI assigned

Sep 23, 2010

Last updated

Jun 30, 2011By 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. Todd Weiss

Title

Owner

Phone

(618) 532-7777

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1225346356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 N POPLAR ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628012965",
            "telephone_number": "877-446-5093",
            "fax_number": "816-841-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 N POPLAR ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628012965",
            "telephone_number": "618-532-7777",
            "fax_number": "618-532-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ANGELS EMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-23",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-532-7777",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "9999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.