Forman Ambulance Service

LBN: Forman Ambulance Service
Forman Ambulance Service is an health care organization with primary practice located at 205 N Broadway , Manito IL 61546-0648. The organization recently has only one registered license in Transportation Services / Air Transport, which is considered as the primary health care specialty. Forman Ambulance Service can be contacted via phone (309) 968-6902, or through Bortell, Sheron Kaye via phone (309) 968-6902.

Contact Information

Primary practice address
205 N Broadway Manito IL 61546-0648
Phone: (309) 968-6902
Fax: (309) 968-6649
Website:
Map and Directions
Authorized official contact:
Name: Bortell, Sheron Kaye
Phone: (309) 968-6902

Health care specialties

SpecialtyCodeLicense #State
Transportation Services / Air Transport 3416A0800X 1660298 Illinois

Profile Details

NPI number 1700871910
LBN Legal business name Forman Ambulance Service
DBA Doing business as
Authorized official Bortell, Sheron Kaye
Entity Organization
Organization subpart 1 No
Enumeration date Sep 14th, 2005
Last updated May 11th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700871910 NPPES
Illinois MEDICAID 237154244001

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