# ELIZABETH COMMUNITY AMBULANCE SERVICE

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

## Provider details

- **NPI number:** 1245224138
- **Authorized official:** E RUDY PASCOE (COORDINATOR)
- **Authorized official phone:** (815) 858-2404

## Contact information

- **Practice address:** 111 E MYRTLE ST, ELIZABETH, IL 61028-9794
- **Practice address phone:** (815) 858-2404
- **Mailing address:** 111 E MYRTLE ST, P O BOX 325, ELIZABETH, IL 61028-9794
- **Mailing address phone:** (815) 858-2404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 1595013 | IL | Yes |

## Other

- **Enumeration date:** 09/07/2005
- **Last updated:** 09/06/2023