# CITY OF COLUMBIA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** City of Columbia Ambulance Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669571337
- **Authorized official:** SHANNON D BOUND (ADMIN. ASSISTANT)
- **Authorized official phone:** (618) 281-4163

## Contact information

- **Practice address:** 1020 N MAIN ST, COLUMBIA, IL 62236
- **Practice address phone:** (618) 281-4163
- **Practice address fax:** (618) 281-6133
- **Mailing address:** PO BOX 467, COLUMBIA, IL 62236
- **Mailing address phone:** (618) 281-4163
- **Mailing address fax:** (618) 281-6133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 044152 | IL | Yes |
| 3416L0300X | Land Ambulance | 4831 | IL | — |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 05/14/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0006790001 | BCBS PROVIDER NUMBER | IL |
| 05 | — | 001 | — | IL |
| 01 | — | 590155450 | RRMC PROVIDER NUMBER | IL |