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Organization

BROWN COUNTY

Active
Other names
Brown County Ambulance Service
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRIAN JAMES GALLAHER I EMT-P (AMBULANCE DIRECTOR)
(217) 773-2113
Entity
Organization

Contact information

Practice address
835 ROUTE 24 WEST, MT STERLING, IL 62353-9408
(217) 773-2113
(217) 773-2090
Mailing address
835 ROUTE 24 WEST, MT STERLING, IL 62353-9408
(217) 773-2113
(217) 773-2090

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
3454
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
376000422001
IL
01
570871
BLUE CROSS BLUE SHIELD
IL
01
590007560
RAILROAD MEDICARE
IL
01
P00124502
RAILROAD MEDICARE
IL
Enumeration date
07/04/2006
Last updated
02/10/2010
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