Organization
WILLIAMSON COUNTY AMBULANCE SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY L COLYER (PRESIDENT)
(618) 922-8670
Entity
Organization
Contact information
Practice address
808 E DEYOUNG ST, MARION, IL 62959-3333
(618) 997-4915
(618) 993-3386
Mailing address
808 E DEYOUNG ST, MARION, IL 62959-3333
(618) 997-4915
(618) 993-3386
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
Primary
5210
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027487
HEALTH ALLIANCE
—
01
—
087931100
DOL BLACK LUNG
—
01
—
10070554
BLUE CROSS BLUE SHIELD
IL
01
—
113139
HEALTHLINK, INC
—
01
—
590155539
RAILROAD MEDICARE
—
01
—
8181435
UNITED HEALTHCARE
—
Enumeration date
10/10/2006
Last updated
07/29/2019
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