Henry Community Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

22530 Issued in IL

Legal business name

HENRY COMMUNITY AMBULANCE SERVICE

Practice address

216 Railroad Ave
Henry, IL 61537-1325

Phone

(309) 364-3323

Fax

(309) 364-3320

NPI assigned

Oct 14, 2006

Last updated

Mar 23, 2012By 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

Mrs. Sarah E Bogner

Title

Director

Phone

(309) 364-3323

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1160784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1770673170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 RAILROAD AVE",
            "city": "HENRY",
            "state": "IL",
            "postal_code": "615371325",
            "telephone_number": "309-364-3323",
            "fax_number": "309-364-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 RAILROAD AVE",
            "city": "HENRY",
            "state": "IL",
            "postal_code": "615371325",
            "telephone_number": "309-364-3323",
            "fax_number": "309-364-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY COMMUNITY AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-14",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "BOGNER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "309-364-3323",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "22530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590003294",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Victor Flores
• David A Forbes, DC
• Celeste Elaine Hansen, OTR
• Heartland of Henry Il, LLC (Heartland Health Care Center - Henry)
• Betty Louise Heinold, COTA
• Henry Rehab and Nursing LLC
• Henry Senachwine Cusd 5
• Highland Park CVS, L.L.C. (CVS Pharmacy #10656)
• Julia Rackley Perry Memorial Hospital (Perry Memorial Henry Clinic)
• Julia Rackley Perry Memorial Hospital (Perry Memorial Henry Clinic)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.