# WILLIAMSON COUNTY AMBULANCE SERVICE, INC

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

## Provider details

- **NPI number:** 1255428140
- **Authorized official:** RICKY L COLYER (PRESIDENT)
- **Authorized official phone:** (618) 922-8670

## Contact information

- **Practice address:** 808 E DEYOUNG ST, MARION, IL 62959-3333
- **Practice address phone:** (618) 997-4915
- **Practice address fax:** (618) 993-3386
- **Mailing address:** 808 E DEYOUNG ST, MARION, IL 62959-3333
- **Mailing address phone:** (618) 997-4915
- **Mailing address fax:** (618) 993-3386

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | NULL | — |
| 3416L0300X | Land Ambulance | 5210 | IL | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 07/29/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 027487 | HEALTH ALLIANCE | — |
| 01 | — | 087931100 | DOL BLACK LUNG | — |
| 01 | — | 10070554 | BLUE CROSS BLUE SHIELD | IL |
| 01 | — | 113139 | HEALTHLINK, INC | — |
| 01 | — | 590155539 | RAILROAD MEDICARE | — |
| 01 | — | 8181435 | UNITED HEALTHCARE | — |