Organization
LEROY EMERGENCY AMBULANCE SERVICE INC
Active
Parent organization
LEROY EMERGENCY AMBULANCE SERVICE INC
Other names
LeRoy Emergency Ambulance Service Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEROY EMERGENCY AMBULANCE SERVICE INC
Authorized official
LAURA WILLIS (ADMINISTRATOR)
(309) 962-6114
Entity
Organization
Contact information
Practice address
303 S EAST ST, LE ROY, IL 61752-1869
(309) 962-6114
(309) 962-5054
Mailing address
PO BOX 36, LE ROY, IL 61752-0036
(309) 962-6114
(309) 962-5054
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
36734
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05730181
BLUE CROSS BLUE SHIELD
IL
01
—
791590694
PALMETTO GBA
IL
Enumeration date
02/02/2007
Last updated
07/05/2023
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