Provider Demographics
NPI:1073530887
Name:MT. OLIVE AREA AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:MT. OLIVE AREA AMBULANCE SERVICE, INC.
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF SERVICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCHOEN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT/BD
Authorized Official - Phone:217-999-7412
Mailing Address - Street 1:815 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:IL
Mailing Address - Zip Code:62069-1501
Mailing Address - Country:US
Mailing Address - Phone:217-999-7412
Mailing Address - Fax:217-999-7412
Practice Address - Street 1:815 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:IL
Practice Address - Zip Code:62069-1501
Practice Address - Country:US
Practice Address - Phone:217-999-7412
Practice Address - Fax:217-999-7412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL33436341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance