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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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