Provider Demographics
NPI:1659685964
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:217-383-4059
Mailing Address - Street 1:210 E UNIVERSITY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3846
Mailing Address - Country:US
Mailing Address - Phone:217-356-3429
Mailing Address - Fax:217-356-0794
Practice Address - Street 1:210 E UNIVERSITY AVE STE A
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-3846
Practice Address - Country:US
Practice Address - Phone:217-356-3429
Practice Address - Fax:217-356-0794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILEMS 628253416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL371140016002Medicaid