Organization
BISMARCK COMMUNITY AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA SWALLOW (COORDINATOR)
(217) 649-5097
Entity
Organization
Contact information
Practice address
16903 E 2750 N RD, BISMARCK, IL 61814
(217) 759-3164
Mailing address
PO BOX 65, BISMARCK, IL 61814-0065
(217) 759-3164
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
006693
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611124900
BLACK LUNG
—
01
—
9232001
BLUE CROSS
—
Enumeration date
10/04/2006
Last updated
04/28/2013
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