Organization
TRI-CITY AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA ERICKSON (ACCOUNTING MANAGER)
(630) 377-4487
Entity
Organization
Contact information
Practice address
2 E MAIN ST, ST CHARLES, IL 60174-1926
(630) 377-4987
(630) 377-4487
Mailing address
PO BOX 457, WHEELING, IL 60090-0457
(847) 577-8811
(847) 577-7967
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
7237
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4532365
BCBS
IL
Enumeration date
08/29/2006
Last updated
04/20/2008
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