Provider Demographics
NPI:1962476119
Name:GALENA AREA EMERGENCY MEDICAL SERVICE DISTRICT
Entity Type:Organization
Organization Name:GALENA AREA EMERGENCY MEDICAL SERVICE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:FRANGELLA FINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-777-3575
Mailing Address - Street 1:217 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:IL
Mailing Address - Zip Code:61036-1635
Mailing Address - Country:US
Mailing Address - Phone:815-777-3575
Mailing Address - Fax:815-777-8329
Practice Address - Street 1:217 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:IL
Practice Address - Zip Code:61036
Practice Address - Country:US
Practice Address - Phone:815-777-3575
Practice Address - Fax:815-777-8329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1032341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
204860Medicare ID - Type Unspecified