Organization
ALHAMBRA AMBULANCE SERVICE FUND
Active
Other names
Alhambra - Hamel Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE M LOGUE PARAMEDIC (MANAGER)
(618) 633-2205
Entity
Organization
Contact information
Practice address
401 OLD RTE 66 NORTH, HAMEL, IL 62046
(618) 633-2205
(618) 633-2110
Mailing address
401 OLD RTE 66 NORTH, PO BX 261, HAMEL, IL 62046
(618) 633-2205
(618) 633-2110
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
4 4821
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590155602
RAIL ROAD MEDICARE
IL
Enumeration date
02/02/2007
Last updated
02/20/2012
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