Organization
CITY OF KEITHSBURG
Active
Other names
VOLUNTEER AMBULANCE SERVICE OF KEITHSBURG
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH L BROWN (TREASURER)
(309) 374-2414
Entity
Organization
Contact information
Practice address
202 S 6TH ST, KEITHSBURG, IL 61442-5033
(309) 374-2220
Mailing address
601 WASHINGTON ST, KEITHSBURG, IL 61442-9627
(309) 374-2414
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
000002555
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362958288001
—
IL
Enumeration date
12/01/2006
Last updated
05/21/2012
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