NPI 1235397282

Medstar Ambulance INC

Organisation Land Ambulance Sparta, IL

Practice location

Address: 705 Bradbury Ln, Sparta, IL 62286-2102
Phone: (618) 443-5061
Fax: (618) 443-3897
Mailing address: PO Box 296, Sparta, IL 62286-0296

Authorised official

Name: Deborah D Kelley
Title: Human Resource Manager
Phone: (618) 443-5061

Registered specialties

Land Ambulance Primary

Transportation Services Taxonomy 3416L0300X Licence 4837 (IL)

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Registry record

NPI: 1235397282
Entity type: Organization
NPI issued: 27 May 2008
Record last updated: 27 May 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.