City of Ottawa Illinois
Organization Active NPI Land Ambulance · Ottawa, IL
NPI 1477592798 · NPPES record last updated Apr 1, 2013
Key facts
- NPI
- 1477592798
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 2963 (IL)
- Legal business name
- CITY OF OTTAWA ILLINOIS
- Practice address
- 301 W Lafayette St
Ottawa, IL 61350-5700 - Phone
- (815) 434-3785
- Fax
- (815) 434-3805
- NPI assigned
- Jun 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Jeff Newbury
- Title
- Fire Chief
- Phone
- (815) 434-3785
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081016000216 | IL | Part B Supplier - Ambulance Service Supplier | 0547328742 | Practice locations: Ottawa, IL |
National Provider Directory
Locations
301 W Lafayette St
Ottawa, IL 61350
Phone (815) 434-3785
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 2963 | IL | Yes |
Addresses
Primary practice location
301 W Lafayette St
Ottawa, IL 61350-5700
Mailing address
PO Box 260
Mendota, IL 61342-0260
Phone (815) 539-2468
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05032006 | Other | IL | BCBS |
| 611185500 | Other | IL | DOL / OWCP |
| 590008306 | Other | IL | RR MEDICARE |
Other names
- Ottawa Fire Department
Other providers in Ottawa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2013. 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.