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General NPI Number Information
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NPI Number | 1902944275
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Entity Type | Organization
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Legal Business Name | SAVANNA COMMUNITY AMBULANCE ASSOCIATION
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 827 CHICAGO AVE
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City | SAVANNA
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State | IL
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Zip | 61074-2217
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Country | US
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Telephone | 815-273-7002
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Fax | 815-273-3008
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Provider Business Mailing Address
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Address Line | PO BOX 331
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City | SAVANNA
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State | IL
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Zip | 61074-0331
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Country | US
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Telephone | 815-273-7002
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Fax | 815-273-3008
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LOUISE BROUILLARD
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Credential | EMT-PARAMEDIC
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Telephone | 815-273-7002
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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 | 1722903
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License Number State | IL
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