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Organization
VILLAGE OF GREENUP
Active
Organization
VILLAGE OF GREENUP
Active
Other names
Greenup Community Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
JILL KIMBLE (VILLAGE CLERK)
(217) 923-3401
Entity
Organization
Contact information
Practice address
115E CUMBERLAND STREET, GREEENUP, IL 62428-0246
(217) 923-3401
(217) 923-3424
Mailing address
PO BOX 246, 115 E CUMBERLAND STREET, GREENUP, IL 62428-0246
(217) 923-3401
(217) 923-3424
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
66765
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01821622
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/06/2007
Last updated
10/11/2021
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