Organization
OSF LIFELINE AMBULANCE, LLC
Active
Parent organization
OSF HEALTHCARE SYSTEM
Organization subpart
Yes
Provider details
NPI number
Legal business name
OSF HEALTHCARE SYSTEM
Authorized official
JAMES M MOORE (CEO)
(309) 655-2850
Entity
Organization
Contact information
Practice address
318 ROXBURY RD, ROCKFORD, IL 61107-5090
(815) 395-4695
(805) 395-4643
Mailing address
PO BOX 17115, ROCKFORD, IL 61110-7115
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
471203
BLUE CROSS
IL
Enumeration date
12/06/2006
Last updated
04/09/2014
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