PINCKNEYVILLE AMBULANCE SERVICE (NPI# 1013960715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013960715 |
Entity Type | Organization |
Organization Name | PINCKNEYVILLE AMBULANCE SERVICE |
Other Organization Name | PINCKNEYVILLE AMBULANCE SERVICE |
Practice Address |
508 S Main St Pinckneyville IL 62274-1740 |
Practice Telephone | 6183572222 |
Practice Fax Number | 6183576512 |
Mailing Telephone | 6183572222 |
Mailing Fax Number | 6183576512 |
Enumeration Date | 2006-05-17 |
Last Update Date | 2012-05-08 |
Authorized Official Name | MRS. PATSY G. LIPE (OFFICE MANAGER) |
Authorized Official Telephone | 6183572222 |
Authorized Official Credential | PARAMEDIC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3416L0300X |
Ambulance Specialization: Land Transport |
55158 | IL | Transportation Services |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | BLACK LUNG PROGRAM | 898518 | 01 |
IL | N269676 | 05 | |
IL | BLUE CROSS BLUE SHIELD | 07370132 | 01 |
OH | 2633994 | 05 |
Other Name | Type Code |
---|---|
Pinckneyville Ambulance Service | Doing Business As Name - Organization |
Street Address |
508 S MAIN ST |
City | PINCKNEYVILLE |
State | IL |
Zip Code | 62274-1740 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912260233 | Kathy Lynn Heard | Physical Therapy Assistant | 101 N. Walnut St., Pinckneyville, IL 62274 | 2012-06-21 |
1235254350 | Timothy Alan Mathis | Emergency Medicine | 202 S Walnut St, Pinckneyville, IL 62274 | 2007-03-20 |
1225194988 | Perry County Trans Van | Non-emergency Medical Transport (VAN) | 602 S Douglas St, Pinckneyville, IL 62274 | 2006-12-28 |
1063591261 | Medical Arts Sc | Family Medicine | 13 North Walnut Street, Pinckneyville, IL 62274 | 2006-11-06 |
1588670426 | Ralph Kane Chapman | Dentist | Box 469, 314 W South St, Pinckneyville, IL 62274 | 2006-07-31 |
1427456961 | Alisa D Dearmond | Nurse Practitioner | 5383 State Route 154, Pinckneyville, IL 62274 | 2014-12-16 |
1619210721 | Andrea Marie Epplin | Nurse Practitioner | 5383 State Route 154, Family Medical Center, Pinckneyville, IL 62274 | 2013-03-27 |
1841336799 | Clinic Pharmacy | Pharmacy | 206 North Main Street, Pinckneyville, IL 62274-0364 | 2007-01-29 |
1992840821 | Wayne Ray Hawkins | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2007-02-20 |
1194384669 | Thaddeus Hawkins | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2019-06-10 |
Find all providers in zip 62274 |
Taxonomy Code | 3416L0300X |
Grouping | Transportation Services |
Classification | Ambulance |
Specialization | Land Transport |
Definition to come... |
Notes: [1/1/2005: title modified] |
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1417472739 | City of Benton | Ambulance | 107 N. Maple St., Benton, IL 62812 | 2017-08-08 |
1619499878 | Mission Care of Illinois LLC | Ambulance | 812 N 3rd St, Effingham, IL 62401-3130 | 2017-07-10 |
Find all providers with the same taxonomy |
City | PINCKNEYVILLE |
Zip Code | 62274 |
Please comment or provide details below to improve the information on PINCKNEYVILLE AMBULANCE SERVICE.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.