# WYOMING AMBULANCE SERVICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154455723
- **Authorized official:** ARDITH WITTMEYER (TREASURER)
- **Authorized official phone:** (309) 695-5933

## Contact information

- **Practice address:** 610 N MAIN, WYOMING, IL 61491-0204
- **Practice address phone:** (309) 695-5002
- **Mailing address:** PO BOX 204, 610 N MAIN ST, WYOMING, IL 61491-0204
- **Mailing address phone:** (309) 695-5002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 22984 | NULL | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 364L02602001 | — | IL |