Organization
HENRY COMMUNITY AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAH E BOGNER (DIRECTOR)
(309) 364-3323
Entity
Organization
Contact information
Practice address
216 RAILROAD AVE, HENRY, IL 61537-1325
(309) 364-3323
(309) 364-3320
Mailing address
216 RAILROAD AVE, HENRY, IL 61537-1325
(309) 364-3323
(309) 364-3320
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
22530
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590003294
RAILROAD MEDICARE
IL
Enumeration date
10/14/2006
Last updated
03/23/2012
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