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General NPI Number Information
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NPI Number | 1396810180
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Entity Type | Organization
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Legal Business Name | AOW AMBULANCE SERVICE INC. NFP
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 12/07/2021
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Provider Practice Location Address
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Address Line | 310 W. WILLARD STREET
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City | WATAGA
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State | IL
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Zip | 61488-0443
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Country | US
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Telephone | 309-483-6365
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Fax | 309-375-9260
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Provider Business Mailing Address
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Address Line | PO BOX 443
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City | ONEIDA
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State | IL
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Zip | 61467-0443
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Country | US
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Telephone | 309-368-6468
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Fax | 309-341-1945
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Authorized Official
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Title or Position | DIRECTOR
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Name | SALLY J. KEENER
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Credential |
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Telephone | 309-368-6468
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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 | 2549
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License Number State | IL
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