Provider Demographics
NPI:1831280759
Name:MILLER EMS INC.
Entity Type:Organization
Organization Name:MILLER EMS INC.
Other - Org Name:MED FORCE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-273-4911
Mailing Address - Street 1:1011 STATE ST
Mailing Address - Street 2:PO BOX 474
Mailing Address - City:ELDORADO
Mailing Address - State:IL
Mailing Address - Zip Code:62930-1649
Mailing Address - Country:US
Mailing Address - Phone:618-273-4911
Mailing Address - Fax:618-273-7133
Practice Address - Street 1:1011 STATE ST
Practice Address - Street 2:
Practice Address - City:ELDORADO
Practice Address - State:IL
Practice Address - Zip Code:62930-1649
Practice Address - Country:US
Practice Address - Phone:618-273-4911
Practice Address - Fax:618-273-7133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL5003341600000X
IL050033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL083320023OtherBLUE CROSS
ILP00079238OtherRAILROAD MEDICARE
IL=========001Medicaid
IL=========OtherTRICARE NORTH
IL205478Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
IL=========001Medicaid
IL083320023OtherBLUE CROSS