Organization
IRA BURROUGHS
Active
Other names
Laughlin Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
IRA BURROUGHS (DIRECTOR)
(618) 667-7495
Entity
Organization
Contact information
Practice address
205 EDWARDSVILLE RD, TROY, IL 62294-1301
(618) 667-7495
(618) 667-8114
Mailing address
205 EDWARDSVILLE RD, TROY, IL 62294-1301
(618) 667-7495
(618) 667-8114
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
44876
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370948173001
—
IL
Enumeration date
02/26/2007
Last updated
01/15/2008
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