Organization
TRI DISTRICT EMERGENCY AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD L KOELLING (PRESIDENT / SUPERVISOR)
(815) 865-5153
Entity
Organization
Contact information
Practice address
7563 IL ROUTE 75, ROCK CITY, IL 61070-0117
(815) 865-5153
(815) 865-5153
Mailing address
P.O. BOX 117, 7563 IL ROUTE 75, ROCK CITY, IL 61070-0117
(815) 865-5153
(815) 865-5153
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
01103601
IL
146M00000X
Intermediate Emergency Medical Technician
—
—
Other
Enumeration date
05/29/2007
Last updated
03/28/2012
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