Organization
KANSAS AMBULANCE CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN JANE BAKER (BILLING AGENT)
(309) 682-5280
Entity
Organization
Contact information
Practice address
202 N FRONT STREET, KANSAS, IL 61933
(309) 682-5280
(309) 682-5327
Mailing address
202 N FRONT STREET, KANSAS, IL 61933
(309) 682-5280
(309) 682-5327
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1746453
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002332003
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/27/2007
Last updated
04/20/2008
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