Provider Demographics
NPI:1831295252
Name:HILLSBORO AREA AMBULANCE SERVICE INC
Entity type:Organization
Organization Name:HILLSBORO AREA AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ULRICI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-532-9562
Mailing Address - Street 1:PO BOX 523
Mailing Address - Street 2:120 NORTH MAIN
Mailing Address - City:HILLSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62049
Mailing Address - Country:US
Mailing Address - Phone:217-532-9562
Mailing Address - Fax:217-532-9608
Practice Address - Street 1:1140 SCHOOL ST
Practice Address - Street 2:HILLSBORO AREA AMBULANCE SERVICE INC
Practice Address - City:HILLSBORO
Practice Address - State:IL
Practice Address - Zip Code:62049-1932
Practice Address - Country:US
Practice Address - Phone:217-532-2213
Practice Address - Fax:217-532-2215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid