Organization
STARK COUNTY AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES LEONARD ROESNER CEO (OWNER DIRECTOR)
(309) 286-7154
Entity
Organization
Contact information
Practice address
114 N FRANKLIN ST, TOULON, IL 61483
(309) 286-7154
(309) 286-0028
Mailing address
114 NORTH FRANKLIN STREET POB 236, TOULON, IL 61483-0236
(309) 286-7154
(309) 286-0028
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
2574
IL
3416L0300X
Land Ambulance
2574
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00047628
RAILROAD MEDICARE CARRIER
IL
Enumeration date
08/12/2006
Last updated
08/21/2018
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