Organization
BLACKHAWK MEDICAL TRANSPORTATION, INC.
Active
Parent organization
AMB TRAN GROUP, LTD
Other names
VANDENBERG AMBULANCE
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMB TRAN GROUP, LTD
Authorized official
MR. CHRISTOPHER J VANDENBERG (TREASURER)
(708) 532-1613
Entity
Organization
Contact information
Practice address
8400 183RD PL, TINLEY PARK, IL 60477-9268
(708) 532-1613
Mailing address
8400 183RD PL, TINLEY PARK, IL 60487-9205
(708) 532-1613
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
8959
IL
343900000X
Non-emergency Medical Transport (VAN)
3459
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004598029
AETNA
IL
01
—
0009932136
BLUE CROSS BLUE SHIELD
IL
01
—
590013754
RAILROAD MEDICARE
IL
01
—
8100050
UNITED HEALTHCARE
IL
Enumeration date
05/27/2006
Last updated
01/23/2013
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