SOUTH EAST LIVINGSTON COUNTY AMBULANCE SERVICE INC NPI 1407856974

NPI Information

NPI: 1407856974
Provider Name: SOUTH EAST LIVINGSTON COUNTY AMBULANCE SERVICE, INC

Doing Business As: SELCAS AMBULANCE

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
311 E CHESTNUT ST
FAIRBURY, IL
ZIP 61739
Phone: (815) 692-3452
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SOUTH EAST LIVINGSTON COUNTY AMBULANCE SERVICE, INC is a land transport ambulance in Fairbury, IL. SOUTH EAST LIVINGSTON COUNTY AMBULANCE SERVICE, INC NPI is 1407856974. The provider is registered as an organization entity type.
The provider Is Doing Business As Selcas Ambulance.

The provider's business location address is:

311 E CHESTNUT ST
FAIRBURY, IL
ZIP 61739-664
Phone: (815) 692-3452
Fax: (815) 692-2414

The provider's authorized official is James R Hargitt .
The authorized official title is Ems Coordinator and has the following contact phone number (815) 692-3658.

The CLIA number assigned to this NPI record is 14D0892371 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/27/2005 and was last updated on 6/17/2008.

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	26721	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	=========001	MEDICAID	ILLINOIS
2	5390005	OTHER	ILLINOIS	BCBS OF IL PROVIDER #
3	590011250	OTHER	ILLINOIS	RAILROAD MEDICARE
4	268910	MEDICARE PIN	ILLINOIS

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

NPI Synchronization or Removal

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