Active NPI
Andalusia Volunteer Ambulance
- Land Ambulance
- Andalusia, IL
National Provider Identifier
1548375769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 22560
- Legal business name
- ANDALUSIA VOLUNTEER AMBULANCE
- Practice address
- 220 6TH Ave. W.
Andalusia, IL 61232-0265 - Phone
- (309) 798-5406
- Fax
- (309) 798-5406
- NPI assigned
- Aug 20, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cindy Cullen
- Title
- Business Manager
- Phone
- (309) 798-5406
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 22560 | IL | Primary |
Addresses
Primary practice location
220 6TH Ave. W.
Andalusia, IL 61232-0265
Mailing address
220 6TH Ave. W.
PO Box 265
Andalusia, IL 61232-0265
Phone (309) 798-5406
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071026000727 | IL | Part B Supplier - Ambulance Service Supplier | 4880781582 | Practice locations: Andalusia, IL |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1548375769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 6TH AVE. W.",
"address_2": "PO BOX 265",
"city": "ANDALUSIA",
"state": "IL",
"postal_code": "612320265",
"telephone_number": "309-798-5406",
"fax_number": "309-798-5406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 6TH AVE. W.",
"city": "ANDALUSIA",
"state": "IL",
"postal_code": "612320265",
"telephone_number": "309-798-5406",
"fax_number": "309-798-5406"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ANDALUSIA VOLUNTEER AMBULANCE",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-20",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "CULLEN",
"authorized_official_first_name": "CINDY",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "309-798-5406"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "IL",
"license": "22560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andalusia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.