Organization
COUNTY OF ALEXANDER ALEXANDER COUNTY COURT HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN R BIGHAM (DIRECTOR)
(618) 776-5958
Entity
Organization
Contact information
Practice address
26711 STATE HIGHWAY 3, OLIVE BRANCH, IL 62969-0190
(618) 776-5958
(618) 776-5960
Mailing address
PO BOX 190, 26711 STATE HIGHWAY 3, OLIVE BRANCH, IL 62969-0190
(618) 776-5958
(618) 776-5960
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
690332980001
—
IL
05
—
69033298001
—
IL
Enumeration date
06/29/2006
Last updated
03/22/2021
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