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General NPI Number Information
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NPI Number | 1043414311
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Entity Type | Organization
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Legal Business Name | MORRISONVILLE COMMUNITY AMBULANCE
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 709 SARPY ST
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City | MORRISONVILLE
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State | IL
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Zip | 62546
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Country | US
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Telephone | 217-526-3199
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Fax | 217-526-3192
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Provider Business Mailing Address
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Address Line | PO BOX 641
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City | MORRISONVILLE
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State | IL
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Zip | 62546-0641
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Country | US
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Telephone | 217-526-3199
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Fax | 217-526-3192
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | MRS. JOYCE TAYLOR
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Credential |
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Telephone | 706-643-4613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 3071
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License Number State | IL
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