Organization
HANOVER AMBULANCE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCIA HANSON (SECRETARY OF EMT)
(815) 591-3767
Entity
Organization
Contact information
Practice address
10 FOX STREET, HANOVER, IL 61041
(815) 591-3767
Mailing address
3920 13TH AVE E, SUITE 6, HIBBING, MN 55746-3675
(218) 263-7540
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004370616
BCBS
IL
Enumeration date
08/01/2006
Last updated
10/14/2008
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