Organization
BASHAM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTY BASHAM (PRESIDENT)
(815) 468-0200
Entity
Organization
Contact information
Practice address
386 S LOCUST ST, MANTENO, IL 60950-1604
(815) 468-0200
(815) 468-0600
Mailing address
386 S LOCUST ST, MANTENO, IL 60950-1604
(815) 468-0200
(815) 468-0600
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
—
—
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/03/2006
Last updated
09/11/2025
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