Organization
COUNTY OF WHITE
Active
Other names
White County Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE TROUSDALE (FIRE CHIEF)
(618) 382-2604
Entity
Organization
Contact information
Practice address
314 E CHERRY ST, CARMI, IL 62821-1862
(618) 382-2604
(618) 384-4084
Mailing address
314 E CHERRY ST, PO BOX 339, CARMI, IL 62821-1862
(618) 382-2604
(618) 384-4084
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
5004
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
613693900
DEPT OF LABOR OWCP
IL
01
—
9770572
BCBS
IL
Enumeration date
07/04/2006
Last updated
03/10/2009
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