Healthcare Provider Details

I. General information

NPI: 1598080202
Provider Name (Legal Business Name): KREIDER SERVICES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 S WEST ST
GALENA IL
61036-2552
US

IV. Provider business mailing address

500 ANCHOR RD
DIXON IL
61021-8829
US

V. Phone/Fax

Practice location:
  • Phone: 815-777-9525
  • Fax: 815-777-9599
Mailing address:
  • Phone: 815-288-6691
  • Fax: 815-288-1636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. ARLAN L MCCLAIN
Title or Position: CEO
Credential:
Phone: 815-288-6691