Provider Demographics
NPI:1518181528
Name:HEALTHONE CRITICAL CARE TRANSPORT SERVICES INC
Entity Type:Organization
Organization Name:HEALTHONE CRITICAL CARE TRANSPORT SERVICES INC
Other - Org Name:MEDICONE MEDICAL RESPONSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT-P
Authorized Official - Phone:866-999-6339
Mailing Address - Street 1:14290 GILLIS RD STE A
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-3724
Mailing Address - Country:US
Mailing Address - Phone:866-999-6339
Mailing Address - Fax:866-215-6089
Practice Address - Street 1:1131 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-6101
Practice Address - Country:US
Practice Address - Phone:866-999-6339
Practice Address - Fax:866-215-6089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL50053416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2532033OtherBCBS
IL612312000OtherDEPT OF LABOT OWCP
IL2532033OtherBCBS
IL=========001Medicaid
IL=========001Medicaid
IL612312000OtherDEPT OF LABOT OWCP