Organization
DECATUR AMBULANCE SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID A KRAUSE (VP-ADMINISTRATION)
(217) 362-5931
Entity
Organization
Contact information
Practice address
417 W WOOD ST, DECATUR, IL 62522-3109
(217) 428-8641
(217) 362-5898
Mailing address
417 W WOOD ST, DECATUR, IL 62522-3109
(217) 428-8641
(217) 362-5898
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
66510
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5890002
BLUE CROSS BLUE SHEILD
IL
Enumeration date
10/27/2005
Last updated
08/22/2020
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