| NPI | 1629014774 |
|---|---|
| Doing Business As | STOCKTON COMMUNITY AMBULANCE |
| Entity Type | Organization |
| Authorized Contact | DEBRA J HEIDENREICH President 815-947-3023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 146M00000X Emergency Medical Technician, Intermediate (Licence: IL 100803) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: IL 100803) |
| 146N00000X Emergency Medical Technician, Basic (Licence: IL 100802) | |
| 146M00000X Emergency Medical Technician, Intermediate (Licence: IL 100802) | |
| 3416L0300X Ambulance, Land Transport (Licence: IL 100802) | |
| 3416L0300X Ambulance, Land Transport (Licence: IL 100803) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2011-05-11 |