Provider Demographics
NPI:1508889189
Name:HARDIN COUNTY AMBULANCE SERVICE
Entity Type:Organization
Organization Name:HARDIN COUNTY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:CONKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-285-3232
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:ROSICLARE
Mailing Address - State:IL
Mailing Address - Zip Code:62982-0160
Mailing Address - Country:US
Mailing Address - Phone:618-285-3232
Mailing Address - Fax:618-287-2661
Practice Address - Street 1:1 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROSICLARE
Practice Address - State:IL
Practice Address - Zip Code:62982-0160
Practice Address - Country:US
Practice Address - Phone:618-285-3232
Practice Address - Fax:618-287-2661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL551243416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport