# CITY OF BREESE

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

## Provider details

- **NPI number:** 1265462592
- **Authorized official:** MR. CHARLES HILMES (MAYOR)
- **Authorized official phone:** (618) 526-7731

## Contact information

- **Practice address:** 500 N 1ST ST, BREESE, IL 62230-1624
- **Practice address phone:** (618) 526-4455
- **Practice address fax:** (618) 526-4693
- **Mailing address:** 500 N 1ST ST, BREESE, IL 62230-1624
- **Mailing address phone:** (618) 526-4455

## Taxonomy

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

## Other

- **Enumeration date:** 07/03/2006
- **Last updated:** 06/29/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01470633 | BLUE SHIELD | — |
| 01 | — | 590007558 | RR MEDICARE | — |