Organization
CITY OF COLUMBIA
Active
Other names
City of Columbia Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON D BOUND (ADMIN. ASSISTANT)
(618) 281-4163
Entity
Organization
Contact information
Practice address
1020 N MAIN ST, COLUMBIA, IL 62236
(618) 281-4163
(618) 281-6133
Mailing address
PO BOX 467, COLUMBIA, IL 62236
(618) 281-4163
(618) 281-6133
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
044152
IL
3416L0300X
Land Ambulance
4831
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006790001
BCBS
IL
05
—
001
—
IL
01
—
590155450
RRMC PROVIDER NUMBER
IL
Enumeration date
09/21/2006
Last updated
05/14/2012
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