Organization
CITY OF OFALLON
Active
Other names
OFALLON EMS
Organization subpart
No
Provider details
NPI number
Authorized official
JIM HOLLEY (SUPERVISOR)
(800) 538-8278
Entity
Organization
Contact information
Practice address
285 N 7 HILLS RD, O FALLON, IL 62269-4110
(800) 538-8278
(580) 628-2273
Mailing address
285 N 7 HILLS RD, O FALLON, IL 62269-4110
(800) 538-8278
(580) 628-2273
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
4865
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008220726
BCBS PROVIDER NUMBER
IL
01
—
590009903
RRMC PROVIDER NUMBER
IL
Enumeration date
10/26/2006
Last updated
09/19/2012
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