Organization
VILLAGE OF GREENUP
Active
Other names
Greenup Community Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
JILL KIMBLE (VILLAGE CLERK)
(217) 923-3401
Entity
Organization
Contact information
Practice address
115E CUMBERLAND STREET, GREEENUP, IL 62428-0246
(217) 923-3401
(217) 923-3424
Mailing address
PO BOX 246, 115 E CUMBERLAND STREET, GREENUP, IL 62428-0246
(217) 923-3401
(217) 923-3424
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
66765
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01821622
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/06/2007
Last updated
10/11/2021
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