Village of Wayne City
Organization Active NPI Land Ambulance · Wayne City, IL
NPI 1750436002 · NPPES record last updated May 17, 2012
Key facts
- NPI
- 1750436002
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 55160 (IL)
- Legal business name
- VILLAGE OF WAYNE CITY
- Practice address
- 103 Mill Street
Wayne City, IL 62895-0176 - Phone
- (618) 895-2241
- Fax
- (618) 895-2241
- NPI assigned
- Jan 25, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- VILLAGE OF WAYNE CITY
Authorized official
- Name
- Mrs. Vickie L Slater
- Title
- Village of Wayne Clerk
- Phone
- (618) 895-2241
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120905000655 | IL | Part B Supplier - Ambulance Service Supplier | 4284881715 | Practice locations: Wayne City, IL |
National Provider Directory
- Part of
- Village of Wayne City
Locations
103 E Mill St
Wayne City, IL 62895
Phone (618) 895-2241
102 S Main St
Wayne City, IL 62895
302 N Main St
Wayne City, IL 62895
Phone (618) 895-2248
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 55160 | IL | Yes |
Addresses
Primary practice location
103 Mill Street
Wayne City, IL 62895-0176
Mailing address
PO Box 176
Wayne City, IL 62895-0176
Phone (618) 895-2241
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4351483 | Other | CIGNA | |
| 096320212 | Other | BLUECROSS BLUESHIELD | |
| 115266 | Other | HEALTHLINK |
Other names
- Wayne City Ambulance Service
Other providers in Wayne City, IL
- Lisa K Feather
- Sherry Charlette Locey
- Kassi Dawn McCormick
- National Healthcare of Mt Vernon Inc
- National Healthcare of Mt Vernon Inc
- Wayne City Community School District 100
All providers in Wayne City, IL · Land Ambulance in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2012. 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.