# GALLATIN COUNTY AMBULANCE LLC

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

## Provider details

- **NPI number:** 1336233196
- **Authorized official:** RICK L COLYER (PRESIDENT)
- **Authorized official phone:** (618) 997-4915

## Contact information

- **Practice address:** 204 BALTIMORE ST, RIDGWAY, IL 62979
- **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 |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 5210 | IL | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 10/30/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 073719 | HEALTH ALLIANCE | — |
| 01 | — | 10032082 | BLUE CROSS BLUE SHIELD | IL |
| 01 | — | 195037 | HEALTHLINK, INC | — |
| 01 | — | 8100188 | UNITED HEALTHCARE | — |