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Organization
TRI-COUNTY AMBULANCE DISTRICT
Active
Organization
TRI-COUNTY AMBULANCE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT ROGER LAKE (DIRECTOR)
(309) 337-4272
Entity
Organization
Contact information
Practice address
2495 SHEPHERD DR, RIO, IL 61472-9802
(309) 337-4272
Mailing address
PO BOX 97, WOODHULL, IL 61490-0097
(309) 337-4272
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2606
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370999628001
—
IL
Enumeration date
07/11/2006
Last updated
04/26/2024
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