# LEROY EMERGENCY AMBULANCE SERVICE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LEROY EMERGENCY AMBULANCE SERVICE INC
- **Other names:** LeRoy Emergency Ambulance Service Inc
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1528106366
- **Legal business name:** LEROY EMERGENCY AMBULANCE SERVICE INC
- **Authorized official:** LAURA WILLIS (ADMINISTRATOR)
- **Authorized official phone:** (309) 962-6114

## Contact information

- **Practice address:** 303 S EAST ST, LE ROY, IL 61752-1869
- **Practice address phone:** (309) 962-6114
- **Practice address fax:** (309) 962-5054
- **Mailing address:** PO BOX 36, LE ROY, IL 61752-0036
- **Mailing address phone:** (309) 962-6114
- **Mailing address fax:** (309) 962-5054

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 36734 | IL | Yes |

## Other

- **Enumeration date:** 02/02/2007
- **Last updated:** 07/05/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 05730181 | BLUE CROSS BLUE SHIELD | IL |
| 01 | — | 791590694 | PALMETTO GBA | IL |