Organization
CITY OF ROCKFORD
Active
Other names
Rockford Emergency Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
GREG CASTRONOVO (CHIEF)
(815) 987-5663
Entity
Organization
Contact information
Practice address
204 S 1ST ST, ROCKFORD, IL 61104-2033
(815) 987-5663
Mailing address
PO BOX 8750, CAROL STREAM, IL 60197-8750
(937) 424-3701
(937) 291-2971
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
011398
IL
3416L0300X
Land Ambulance
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10115151
ANTHEM
IL
01
—
590009290
RAILROAD MEDICARE
IL
Enumeration date
02/02/2006
Last updated
07/21/2022
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