MITCHELL-JERDAN FUNERAL HOME LTD NPI 1245453190

NPI Information

NPI: 1245453190
Provider Name: MITCHELL-JERDAN FUNERAL HOME LTD

Other Name: MITCHELL-JERDAN AMBULANCE SERVICE

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
1200 WABASH AVE
MATTOON, IL
ZIP 61938
Phone: (217) 234-8828
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MITCHELL-JERDAN FUNERAL HOME LTD is a land transport ambulance in Mattoon, IL. MITCHELL-JERDAN FUNERAL HOME LTD NPI is 1245453190. The provider is registered as an organization entity type.
The provider Other Name Is Mitchell-jerdan Ambulance Service.

The provider's business location address is:

1200 WABASH AVE
MATTOON, IL
ZIP 61938-142
Phone: (217) 234-8828
Fax: (217) 258-0786

The provider's authorized official is Gregory L. Jerdan .
The authorized official title is President and has the following contact phone number (217) 234-8828.

The enumeration date for this NPI number is 4/10/2007 and was last updated on 3/13/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	66792	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0001570051	OTHER	ILLINOIS	BLUE CROSS BLUE SHIELD
2	168847	OTHER	ILLINOIS	PERSONAL CARE INSURANCE
3	590128024	OTHER	ILLINOIS	RAILROAD MEDICARE
4	593330	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS
5	=========001	MEDICAID	ILLINOIS
6	=========	OTHER	ILLINOIS	OTHER MISCELLANEOUS INS.

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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