Provider Demographics
NPI:1215211545
Name:ARROW AMBULANCE, LLC
Entity Type:Organization
Organization Name:ARROW AMBULANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:CORD
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-411-4558
Mailing Address - Street 1:210 E UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3845
Mailing Address - Country:US
Mailing Address - Phone:217-356-3429
Mailing Address - Fax:217-356-0794
Practice Address - Street 1:216 E WATER ST
Practice Address - Street 2:
Practice Address - City:FARMER CITY
Practice Address - State:IL
Practice Address - Zip Code:61842-1553
Practice Address - Country:US
Practice Address - Phone:217-356-3429
Practice Address - Fax:217-356-0794
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARROW AMBULANCE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-05
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILEMS628253416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL3696Medicare PIN