Organization
CITY OF MASCOUTAH
Active
Other names
Mascoutah Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY GOTTSCHAMMER (SUPERVISOR)
(800) 538-8278
Entity
Organization
Contact information
Practice address
3 W MAIN ST, MASCOUTAH, IL 62258-2030
(800) 538-8278
(580) 628-2273
Mailing address
3 W MAIN ST, MASCOUTAH, IL 62258-2030
(800) 538-8278
(580) 628-2273
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
4851
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590007593
RRMC PROVIDER NUMBER
IL
01
—
8273216
BCBS PROVIDER NUMBER
IL
Enumeration date
10/26/2006
Last updated
06/23/2008
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