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Organization
CITY OF HIGHLAND
Active
Organization
CITY OF HIGHLAND
Active
Other names
Highland Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE L NICKLIN (BILLING)
(618) 651-9801
Entity
Organization
Contact information
Practice address
1122 BROADWAY, HIGHLAND, IL 62249-1917
(618) 654-5901
(618) 654-6829
Mailing address
2610 PLAZA DR, PO BOX 218, HIGHLAND, IL 62249-1123
(618) 651-9801
(618) 654-1901
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1690161
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006019802
BCBS OF IL
IL
01
—
590155556
MEDICARE RAILROAD
IL
Enumeration date
05/24/2006
Last updated
03/27/2009
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