{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "AOW AMBULANCE SERVICE INC. NFP",
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"NamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 443",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ONEIDA",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "61467-0443",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "309-368-6468",
"MailingAddressFaxNumber": "309-341-1945",
"FirstLinePracticeLocationAddress": "310 W. WILLARD STREET",
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"PracticeLocationAddressCityName": "WATAGA",
"PracticeLocationAddressStateName": "IL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "309-483-6365",
"PracticeLocationAddressFaxNumber": "309-375-9260",
"EnumerationDate": "11/21/2006",
"LastUpdateDate": "12/07/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KEENER",
"AuthorizedOfficialFirstName": "SALLY",
"AuthorizedOfficialMiddleName": "J.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "309-368-6468",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "2549",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}