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General NPI Number Information
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NPI Number | 1629169255
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Entity Type | Organization
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Legal Business Name | COUNTY OF PIKE
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 24085 365TH ST
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City | PITTSFIELD
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State | IL
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Zip | 62363-2650
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Country | US
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Telephone | 217-285-9033
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Fax | 217-285-9043
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Provider Business Mailing Address
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Address Line | PO BOX 366
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City | PITTSFIELD
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State | IL
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Zip | 62363-0366
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Country | US
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Telephone | 217-285-6336
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Fax | 217-285-9053
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Authorized Official
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Title or Position | PIKE COUNTY AMBULANCE ADMINISTRATOR
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Name | KASEY KENDALL
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Credential |
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Telephone | 217-285-6336
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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 | 33645
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License Number State | IL
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