# VILLAGE OF MARYVILLE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maryville Village Fire Dept Ambulance Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770530727
- **Authorized official:** DOUGLAS DANKENBRING (FIRE CHIEF)
- **Authorized official phone:** (618) 344-8099

## Contact information

- **Practice address:** 300 N DONK AVE, MARYVILLE, IL 62062-2041
- **Practice address phone:** (618) 344-8099
- **Practice address fax:** (618) 344-2990
- **Mailing address:** 2520 N CENTER ST, MARYVILLE, IL 62062-5671
- **Mailing address phone:** (800) 962-1484
- **Mailing address fax:** (513) 772-4464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 4 4868 | IL | Yes |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 07/23/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 216357500 | DOL OWCP | IL |
| 01 | — | 590007562 | PALMETTO RR MEDICARE | IL |
| 01 | — | 6032131 | BCBS | IL |