# KANSAS AMBULANCE CO

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

## Provider details

- **NPI number:** 1508048067
- **Authorized official:** MS. MARILYN JANE BAKER (BILLING AGENT)
- **Authorized official phone:** (309) 682-5280

## Contact information

- **Practice address:** 202 N FRONT STREET, KANSAS, IL 61933
- **Practice address phone:** (309) 682-5280
- **Practice address fax:** (309) 682-5327
- **Mailing address:** 202 N FRONT STREET, KANSAS, IL 61933
- **Mailing address phone:** (309) 682-5280
- **Mailing address fax:** (309) 682-5327

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 1746453 | IL | Yes |

## Other

- **Enumeration date:** 11/27/2007
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0002332003 | BLUE CROSS BLUE SHIELD | IL |