Provider Demographics
NPI:1275674640
Name:FARMER CITY AMBULANCE SRVC INC
Entity Type:Organization
Organization Name:FARMER CITY AMBULANCE SRVC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:STIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-928-2111
Mailing Address - Street 1:105 S MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FARMER CITY
Mailing Address - State:IL
Mailing Address - Zip Code:61842-1453
Mailing Address - Country:US
Mailing Address - Phone:309-928-2111
Mailing Address - Fax:309-928-3218
Practice Address - Street 1:105 S MAIN STREET
Practice Address - Street 2:
Practice Address - City:FARMER CITY
Practice Address - State:IL
Practice Address - Zip Code:61842-1453
Practice Address - Country:US
Practice Address - Phone:309-928-2111
Practice Address - Fax:309-928-3218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02071191OtherBLUE CROSS BLUE SHIELD
IL=========001Medicaid
IL=========001Medicaid