# VILLAGE OF GREENUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Greenup Community Ambulance Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942330386
- **Authorized official:** JILL KIMBLE (VILLAGE CLERK)
- **Authorized official phone:** (217) 923-3401

## Contact information

- **Practice address:** 115E CUMBERLAND STREET, GREEENUP, IL 62428-0246
- **Practice address phone:** (217) 923-3401
- **Practice address fax:** (217) 923-3424
- **Mailing address:** PO BOX 246, 115 E CUMBERLAND STREET, GREENUP, IL 62428-0246
- **Mailing address phone:** (217) 923-3401
- **Mailing address fax:** (217) 923-3424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 66765 | IL | Yes |

## Other

- **Enumeration date:** 03/06/2007
- **Last updated:** 10/11/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01821622 | BLUE CROSS BLUE SHIELD | IL |