Peoria Hospital's Mobile Medical Services

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

22592 Issued in IL

Legal business name

PEORIA HOSPITAL'S MOBILE MEDICAL SERVICES

Doing business as

Advanced Medical Transport of Central IL

Practice address

1718 N Sterling Ave
Peoria, IL 61604-3831

Phone

(309) 494-6215

Fax

(309) 494-6214

NPI assigned

Dec 13, 2006

Last updated

Nov 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Andrew A Rand

Title

Executive Director

Phone

(309) 494-6215

Specialties & licenses 1

Addresses

Other names 1

• Advanced Medical Transport of Central IL Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1699836379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 N STERLING AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043831",
            "telephone_number": "309-494-6215",
            "fax_number": "309-494-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 N STERLING AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616043831",
            "telephone_number": "309-494-6215",
            "fax_number": "309-494-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEORIA HOSPITAL'S MOBILE MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "RAND",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "309-494-6215",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "22592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Medical Transport of Central IL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peoria Ear, Nose and Throat Group, S.C.
• Peoria Eye Clinic, LTD
• Peoria Family Chiropractic LLC
• Peoria Fire Department
• Peoria Hand Surgery, LLC
• Peoria Integrative Medical Center LTD
• Peoria Midwest Equpiment Inc
• Peoria NH LLC (River Crossing of Peoria)
• Peoria Non- Emergency Medical Transport
• Peoria Obstetrics & Gynecology of Central Illinois

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.

Verify at the official NPI Registry.