Provider Demographics
NPI:1740234210
Name:COUNTY OF HANCOCK
Entity Type:Organization
Organization Name:COUNTY OF HANCOCK
Other - Org Name:HANCOCK COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-357-0702
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:IL
Mailing Address - Zip Code:62321-0116
Mailing Address - Country:US
Mailing Address - Phone:217-357-9715
Mailing Address - Fax:217-357-0702
Practice Address - Street 1:2007 E US HIGHWAY 136
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:IL
Practice Address - Zip Code:62321-3418
Practice Address - Country:US
Practice Address - Phone:217-357-9715
Practice Address - Fax:217-357-0702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3 3636146L00000X
IL33636341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulance
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid