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Organization

CITY OF BREESE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHARLES HILMES (MAYOR)
(618) 526-7731
Entity
Organization

Contact information

Practice address
500 N 1ST ST, BREESE, IL 62230-1624
(618) 526-4455
(618) 526-4693
Mailing address
500 N 1ST ST, BREESE, IL 62230-1624
(618) 526-4455

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01470633
BLUE SHIELD
01
590007558
RR MEDICARE
Enumeration date
07/03/2006
Last updated
06/29/2012
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