Organization
PERU VOLUNTEER AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT HANSON (EXECUTIVE DIRECTOR)
(815) 223-1034
Entity
Organization
Contact information
Practice address
111 5TH ST, PERU, IL 61354-2005
(815) 222-4563
(815) 223-1590
Mailing address
111 5TH ST, PERU, IL 61354-2005
(815) 222-4563
(815) 223-1590
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
2 2610
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005070899
BLUE CROSS BLUE SHIELD
IL
01
—
590007398
RAIL ROAD MEDICARE
IL
Enumeration date
08/28/2006
Last updated
06/19/2025
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