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General NPI Number Information
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NPI Number | 1033165675
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Entity Type | Organization
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Legal Business Name | ELGIN MEDI-TRANSPORT, INC.
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 10/07/2022
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Provider Practice Location Address
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Address Line | 672 WING ST
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City | ELGIN
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State | IL
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Zip | 60123-2870
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Country | US
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Telephone | 847-697-0202
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Fax | 847-697-4736
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Provider Business Mailing Address
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Address Line | PO BOX 323
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City | ELGIN
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State | IL
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Zip | 60121-0323
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Country | US
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Telephone | 847-697-0202
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Fax | 847-697-4736
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. ROBIN BARRAZA
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Credential |
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Telephone | 847-697-0202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 9 7029
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License Number State | IL
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