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General NPI Number Information
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NPI Number | 1831280759
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Entity Type | Organization
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Legal Business Name | MILLER EMS INC.
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 1011 STATE ST
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City | ELDORADO
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State | IL
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Zip | 62930-1649
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Country | US
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Telephone | 618-273-4911
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Fax | 618-273-7133
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Provider Business Mailing Address
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Address Line | 1011 STATE ST PO BOX 474
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City | ELDORADO
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State | IL
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Zip | 62930-1649
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Country | US
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Telephone | 618-273-4911
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Fax | 618-273-7133
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Authorized Official
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Title or Position | CFO
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Name | MR. BRAD WILLIAMS
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Credential |
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Telephone | 618-273-4911
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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 | 5003
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 05003
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License Number State | IL
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