Organization
SOUTHWESTERN ILLINOIS COLLEGE
Active
Other names
Alternative Transportation System
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE LYNN KEIM (MEDICAID SPECIALIST)
(618) 239-0749
Entity
Organization
Contact information
Practice address
718 SCHEEL ST, SUITE C, BELLEVILLE, IL 62220-4159
(618) 239-0749
(618) 239-6232
Mailing address
718 SCHEEL ST, SUITE C, BELLEVILLE, IL 62220-4159
(618) 239-0749
(618) 239-6232
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
343800000X
IL
343900000X
Non-emergency Medical Transport (VAN)
Primary
343900000X
IL
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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