Forman Ambulance Service

NPI 1700871910 - Ambulance - 3416A0800X

NPI Details
NPI 1700871910
Enumeration Date 09/14/2005
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name ROBERT N ROBERT
Position ADMINISTRATOR
Phone (309) 968-6902
Fax (309) 968-6649
Practice Location
205 N BROADWAY
MANITO IL, 61546-0648, US
Phone (309) 968-6902
Fax (309) 968-6649
Business Location
PO BOX 648
MANITO IL, 61546-0648, US
Phone (309) 968-6902
Fax (309) 968-6649
Toxanomy
Taxonomy Code 3416A0800X
License State Illinois
License Number 1660298
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According to our database, Forman Ambulance Service NPI is 1700871910, taxonomy code is 3416A0800X and license number is 1660298, license state is located at Illinois. Forman Ambulance Service physically located at 205 N Broadway, Manito IL, 61546-0648. NPI Number 1033115704 has the healthcare provider type.

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1700871910 NPI number is provided on an as is basis without warranty of any kind. 1700871910 is maintained by the National Plan & Provider Enumeration System. The contents of Forman Ambulance Service are for informational purposes only.