Chenoa Ambulance Service Association

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

026709 Issued in IL

Legal business name

CHENOA AMBULANCE SERVICE ASSOCIATION

Doing business as

Casa

Practice address

920 E Cemetery Ave
Chenoa, IL 61726-1239

Phone

(815) 945-7156

Fax

(815) 945-7532

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Phillip D Harland

Title

Treasurer

Phone

(815) 945-7156

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CASA Doing business as

Locations

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217116800000",
    "number": "1679608954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182",
            "address_2": "920 E CEMETERY AVE",
            "city": "CHENOA",
            "state": "IL",
            "postal_code": "617260182",
            "telephone_number": "815-945-7156",
            "fax_number": "815-945-7532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E CEMETERY AVE",
            "city": "CHENOA",
            "state": "IL",
            "postal_code": "617261239",
            "telephone_number": "815-945-7156",
            "fax_number": "815-945-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHENOA AMBULANCE SERVICE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2008-07-27",
        "status": "A",
        "authorized_official_last_name": "HARLAND",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "815-945-7156"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "026709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05732089",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CASA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda K Krutke, FNP-BC
• Tanya L Landrus
• Lavender Rose Dental
• Letitride Inc (Chenoa Rx LTC)
• Letitride Inc (Chenoa rx)

• Land Ambulance in Chenoa, IL
• Providers in Chenoa, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2008; 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.