Organization
NORTHWESTERN AREA AMBULANCE RESCUE SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENE LUTTERL (FIRE CHIEF)
(217) 436-2015
Entity
Organization
Contact information
Practice address
114 E STATE, PALMYRA, IL 62674
(217) 436-2015
(217) 436-2015
Mailing address
PO BOX 457, WHEELING, IL 60090-0457
(847) 577-8811
(847) 577-3518
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
3435
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5932014
BCBS
IL
Enumeration date
01/16/2007
Last updated
04/20/2008
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