# DELAVAN AMBULANCE SERVICE INC

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

## Provider details

- **NPI number:** 1396879896
- **Authorized official:** CINDY SPRINGER (TREASURER)
- **Authorized official phone:** (309) 244-7420

## Contact information

- **Practice address:** 510 S PINE STREET, DELAVAN, IL 61734-0747
- **Practice address phone:** (309) 244-7420
- **Mailing address:** PO BOX 747, 510 S PINE STREET, DELAVAN, IL 61734-0747
- **Mailing address phone:** (309) 244-7420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 22532 | IL | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 05/04/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09070738 | BLUE CROSS BLUE SHIELD | IL |