# AKRON PRINCEVILLE AMBULANCE INC

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

## Provider details

- **NPI number:** 1407030448
- **Authorized official:** ALFRED GARDNER (BOARD PRESIDENT)
- **Authorized official phone:** (309) 682-5280

## Contact information

- **Practice address:** 319 E MAIN STREET, PRINCEVILLE, IL 61559-0021
- **Practice address phone:** (309) 682-5280
- **Practice address fax:** (309) 682-5327
- **Mailing address:** PO BOX 21, 319 E MAIN STREET, PRINCEVILLE, IL 61559-0021
- **Mailing address phone:** (309) 682-5280
- **Mailing address fax:** (309) 682-5327

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 000002611 | IL | Yes |

## Other

- **Enumeration date:** 12/27/2007
- **Last updated:** 03/29/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 07232089 | BLUE CROSS BLUE SHIELD | IL |
| 01 | — | 590004694 | PALMETTO GBA | — |