Organization
CITY OF GRAYVILLE
Active
Other names
CITY OF GRAYVILLE AMBULANCE SERVICE
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY ANNE JUDGE (PAYROLL CLERK)
(618) 375-3671
Entity
Organization
Contact information
Practice address
122 S COURT ST, GRAYVILLE, IL 62844-1509
(618) 375-3671
(618) 375-7869
Mailing address
122 SOUTH COURT, GRAYVILLE, IL 62844
(618) 375-3671
(618) 375-7869
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
5-51208
IL
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09730354
BCBS
IL
01
—
590009587
RAILROAD
IL
Enumeration date
05/10/2006
Last updated
09/15/2011
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