Gallatin County Ambulance LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

5210 Issued in IL

Legal business name

GALLATIN COUNTY AMBULANCE LLC

Practice address

204 Baltimore St
Ridgway, IL 62979

Phone

(618) 997-4915

Fax

(618) 993-3386

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Rick L Colyer

Title

President

Phone

(618) 997-4915

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1336233196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 E DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629593333",
            "telephone_number": "618-997-4915",
            "fax_number": "618-993-3386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 BALTIMORE ST",
            "city": "RIDGWAY",
            "state": "IL",
            "postal_code": "62979",
            "telephone_number": "618-997-4915",
            "fax_number": "618-993-3386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALLATIN COUNTY AMBULANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "COLYER",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-997-4915"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "5210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "10032082",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "8100188",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK, INC",
            "identifier": "195037",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "073719",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Jo Fromm, RPH
• Gallatin Manor LLC
• James Austin Koester
• Sarah Elizabeth Lawler, COTA/L
• Med Contract, Inc.
• PRN Pharmacies LTD

• All providers in Ridgway, IL
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.