# VILLAGE OF WAYNE CITY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VILLAGE OF WAYNE CITY
- **Other names:** Wayne City Ambulance Service
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1750436002
- **Legal business name:** VILLAGE OF WAYNE CITY
- **Authorized official:** MRS. VICKIE L SLATER (VILLAGE OF WAYNE CLERK)
- **Authorized official phone:** (618) 895-2241

## Contact information

- **Practice address:** 103 MILL STREET, WAYNE CITY, IL 62895-0176
- **Practice address phone:** (618) 895-2241
- **Practice address fax:** (618) 895-2241
- **Mailing address:** PO BOX 176, WAYNE CITY, IL 62895-0176
- **Mailing address phone:** (618) 895-2241
- **Mailing address fax:** (618) 895-2577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 55160 | IL | Yes |

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 05/17/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 096320212 | BLUECROSS BLUESHIELD | — |
| 01 | — | 115266 | HEALTHLINK | — |
| 01 | — | 4351483 | CIGNA | — |