MVK AMBULANCE SERVICE; NPI #1295809739

Contact Information

MVK AMBULANCE SERVICE

604 FRONT ST
MAZON, IL 60444

Phone: 815-448-2134
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulance	341600000X	59	Ambulance Service Provider

Indicates primary specialty

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NPI Profile & details for MVK AMBULANCE SERVICE

NPI # 1295809739

LBN Legal business name MVK AMBULANCE SERVICE

Authorized official TAMARA HALTERMAN - (COORDINATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/17/2006

Last updated 04/20/2011 - About 15 years ago

Identifiers

IL	License #	792201
IL	Other	3221361	BLUE CROSS BLUE SHIELD

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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