Provider Demographics
NPI:1174664551
Name:BYE AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:BYE AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:SPRECHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-358-1352
Mailing Address - Street 1:PO BOX 33
Mailing Address - Street 2:108 E HAWTHORNE
Mailing Address - City:ELMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:61529-7977
Mailing Address - Country:US
Mailing Address - Phone:309-682-5280
Mailing Address - Fax:309-682-5327
Practice Address - Street 1:108 E HAWTHORNE
Practice Address - Street 2:
Practice Address - City:ELMWOOD
Practice Address - State:IL
Practice Address - Zip Code:61529-7977
Practice Address - Country:US
Practice Address - Phone:309-682-5280
Practice Address - Fax:309-682-5327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0000025693416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00101008OtherPALMETTO GBA
IL07232090OtherBLUE CROSS BLUE SHIELD
IL07232090OtherBLUE CROSS BLUE SHIELD
IL630790Medicare PIN