Brown County
Organization Active NPI Land Ambulance · Mt Sterling, IL
NPI 1376573345 · NPPES record last updated Feb 10, 2010
Key facts
- NPI
- 1376573345
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 3454 (IL)
- Legal business name
- BROWN COUNTY
- Practice address
- 835 Route 24 West
Mt Sterling, IL 62353-9408 - Phone
- (217) 773-2113
- Fax
- (217) 773-2090
- NPI assigned
- Jul 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Brian James Gallaher I, EMT-P
- Title
- Ambulance Director
- Phone
- (217) 773-2113
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100219000147 | IL | Part B Supplier - Ambulance Service Supplier | 2466355839 | Practice locations: Mt Sterling, IL |
National Provider Directory
Locations
835 Route 24 W
Mt Sterling, IL 62353
Phone (217) 773-2113
111 W Washington St
Mt Sterling, IL 62353
Phone (217) 773-2714
111 W Washington St
Ste B
Mt Sterling, IL 62353
Phone (217) 773-2714
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 3454 | IL | Yes |
Addresses
Primary practice location
835 Route 24 West
Mt Sterling, IL 62353-9408
Mailing address
835 Route 24 West
Mt Sterling, IL 62353-9408
Phone (217) 773-2113
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 570871 | Other | IL | BLUE CROSS BLUE SHIELD |
| P00124502 | Other | IL | RAILROAD MEDICARE |
| 590007560 | Other | IL | RAILROAD MEDICARE |
| 376000422001 | Medicaid | IL |
Other names
- Brown County Ambulance Service
Other providers in Mt Sterling, IL
- Be Well Therapeutic Center LLC
- Donna Bemis
- Martha E. Blakeley
- Blessing Hospital
- Rochelle L Briney
- Brown County Cu SCH Dist 1
- Brown County Public Health Department
- Kylie Elizabeth Carr
- Charlotte A. Clark
- Shana Clarkson
All providers in Mt Sterling, IL · Land Ambulance in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2010. 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.