Organization
GALLATIN COUNTY AMBULANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK L COLYER (PRESIDENT)
(618) 997-4915
Entity
Organization
Contact information
Practice address
204 BALTIMORE ST, RIDGWAY, IL 62979
(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
3416L0300X
Land Ambulance
Primary
5210
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
073719
HEALTH ALLIANCE
—
01
—
10032082
BLUE CROSS BLUE SHIELD
IL
01
—
195037
HEALTHLINK, INC
—
01
—
8100188
UNITED HEALTHCARE
—
Enumeration date
10/03/2006
Last updated
10/30/2012
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