# IRA BURROUGHS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Laughlin Ambulance Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225164064
- **Authorized official:** IRA BURROUGHS (DIRECTOR)
- **Authorized official phone:** (618) 667-7495

## Contact information

- **Practice address:** 205 EDWARDSVILLE RD, TROY, IL 62294-1301
- **Practice address phone:** (618) 667-7495
- **Practice address fax:** (618) 667-8114
- **Mailing address:** 205 EDWARDSVILLE RD, TROY, IL 62294-1301
- **Mailing address phone:** (618) 667-7495
- **Mailing address fax:** (618) 667-8114

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 44876 | IL | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 01/15/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 370948173001 | — | IL |