Organization
STEPHEN & FRED SHRADER PTR
Active
Other names
Shrader Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE SHRADER (OWNER)
(217) 268-4848
Entity
Organization
Contact information
Practice address
204 N LOCUST ST, ARCOLA, IL 61910-1407
(217) 268-4848
Mailing address
PO BOX 277, 204 N. LOCUST ST, ARCOLA, IL 61910-0277
(217) 268-4848
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
670002
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2190002
BCBS NUMBER
IL
Enumeration date
01/05/2007
Last updated
01/24/2012
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