# CHENOA AMBULANCE SERVICE ASSOCIATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CASA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679608954
- **Authorized official:** PHILLIP D HARLAND (TREASURER)
- **Authorized official phone:** (815) 945-7156

## Contact information

- **Practice address:** 920 E CEMETERY AVE, CHENOA, IL 61726-1239
- **Practice address phone:** (815) 945-7156
- **Practice address fax:** (815) 945-7532
- **Mailing address:** PO BOX 182, 920 E CEMETERY AVE, CHENOA, IL 61726-0182
- **Mailing address phone:** (815) 945-7156
- **Mailing address fax:** (815) 945-7532

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 026709 | IL | Yes |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 07/27/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 05732089 | BLUE CROSS BLUE SHIELD | IL |