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General NPI Number Information
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NPI Number | 1912927385
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Entity Type | Organization
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Legal Business Name | UNITED LIFE CARE AMB SVC INC
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 301 S CROSS ST
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City | ROBINSON
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State | IL
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Zip | 62454-2155
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Country | US
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Telephone | 618-544-3911
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Fax | 724-234-4703
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Provider Business Mailing Address
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Address Line | 301 S CROSS ST
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City | ROBINSON
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State | IL
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Zip | 62454-2155
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Country | US
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Telephone | 618-544-3911
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Fax | 724-234-4703
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW HARGRAVE
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Credential |
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Telephone | 618-562-1193
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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 | 66550
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License Number State | IL
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