Organization
HEYWORTH AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY MOWERY (EMS CAPTAIN)
(309) 261-3126
Entity
Organization
Contact information
Practice address
707 S VINE ST, HEYWORTH, IL 61745-0258
(309) 473-2149
(309) 473-2473
Mailing address
PO BOX 258, 707 S VINE ST, HEYWORTH, IL 61745-0258
(309) 473-2149
(309) 473-2473
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
26737
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590013395
PALMETTO GBA
IL
Enumeration date
02/13/2007
Last updated
02/02/2012
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