Alexis North Henderson Ambulance Service

Organization Active NPI Ambulance · Alexis, IL

NPI 1386733913 · NPPES record last updated May 3, 2012

Key facts

NPI
1386733913
Entity type
Organization (NPI type 2)
Primary specialty
Ambulance 341600000X
License
02 2504 (IL)
Legal business name
ALEXIS NORTH HENDERSON AMBULANCE SERVICE
Practice address
106 E Palmer Ave
Alexis, IL 61412-5152
Phone
(309) 482-6128
Fax
(309) 482-3417
NPI assigned
Oct 12, 2006
Organization subpart
No

Authorized official

Name
Anne Switzer
Title
President
Phone
(309) 221-4643

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120712000113 IL Part B Supplier - Ambulance Service Supplier 9638331804 Practice locations: Alexis, IL; North Henderson, IL

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 02 2504 IL Yes

Addresses

Primary practice location

106 E Palmer Ave
Alexis, IL 61412-5152

Mailing address

PO Box 563
Alexis, IL 61412-0563
Phone (309) 482-6128

Other identifiers

IdentifierTypeStateIssuer
590128733OtherRAILROAD MEDICARE

Other providers in Alexis, IL

All providers in Alexis, IL · Ambulance in Illinois

Sources for this page

Verify at the official NPI Registry.