Organization
ILLIANA EMS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE SHAUGHNESSY (SECRETARY)
(765) 820-5050
Entity
Organization
Contact information
Practice address
700 S MAIN ST, CLINTON, IN 47842-2420
(765) 820-5050
(765) 820-1108
Mailing address
PO BOX 56, CLINTON, IN 47842-0056
(765) 820-5050
(765) 820-1108
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300047213
—
IN
Enumeration date
02/14/2020
Last updated
03/24/2021
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