Organization
FARMERVILLE WAGGONER AREA AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAURICA A MANLEY (BILLING AGENT)
(217) 532-9561
Entity
Organization
Contact information
Practice address
301 SOUTH CLEVELAND, FARMERVILLE WAGGONER AREA AMBULANCE SERVICE, FARMERSVILLE, IL 62533
(217) 227-4121
Mailing address
PO BOX 523, 120 NORTH MAIN, HILLSBORO, IL 62049
(217) 532-9561
(217) 532-9608
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37121591101
—
IL
Enumeration date
10/12/2006
Last updated
08/22/2020
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