Provider Demographics
NPI:1720223001
Name:LA HARPE VOLUNTEER AMBULANCE SERVICE
Entity Type:Organization
Organization Name:LA HARPE VOLUNTEER AMBULANCE SERVICE
Other - Org Name:LA HARPE AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MONALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-333-0961
Mailing Address - Street 1:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:LA HARPE
Mailing Address - State:IL
Mailing Address - Zip Code:61450-0012
Mailing Address - Country:US
Mailing Address - Phone:217-659-3010
Mailing Address - Fax:217-659-3010
Practice Address - Street 1:708 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LA HARPE
Practice Address - State:IL
Practice Address - Zip Code:61450-9161
Practice Address - Country:US
Practice Address - Phone:217-659-3010
Practice Address - Fax:217-659-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL023647341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL023647OtherILLINOIS DEPARTMENT OF PUBLIC HEALTH