Organization
UNITED LIFE CARE AMB SVC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW HARGRAVE (PRESIDENT)
(618) 562-1193
Entity
Organization
Contact information
Practice address
301 S CROSS ST, ROBINSON, IL 62454-2155
(618) 544-3911
(724) 234-4703
Mailing address
301 S CROSS ST, ROBINSON, IL 62454-2155
(618) 544-3911
(724) 234-4703
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
66550
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001723897
BLUE SHIELD
—
01
—
590013091
RAILROAD MEDICARE
—
01
—
610886400
DEPT OF LBOR
IL
Enumeration date
07/20/2006
Last updated
06/20/2024
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