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Organization
GERALD M DUFFY TRUST UW
Active
Organization
GERALD M DUFFY TRUST UW
Active
Other names
Duffy Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTIN M PITTE (TRUSTEE)
(815) 844-7111
Entity
Organization
Contact information
Practice address
122 E HOWARD ST, PONTIAC, IL 61764-1918
(815) 844-7111
(815) 842-1061
Mailing address
202 E HOWARD ST, PONTIAC, IL 61764-1920
(815) 844-7111
(815) 842-1061
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
26718
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001803
HEALTH ALLIANCE
IL
01
—
5390001
BLUE CROSS BLUE SHIELD
IL
01
—
P00221706
RAILROAD MEDICARE
IL
Enumeration date
04/02/2007
Last updated
04/20/2008
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