Provider Demographics
NPI:1538726484
Name:ADVANCED MEDICAL TRANSPORT OF SPRINGFIELD INC
Entity type:Organization
Organization Name:ADVANCED MEDICAL TRANSPORT OF SPRINGFIELD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-494-6215
Mailing Address - Street 1:1718 N STERLING AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61604-3831
Mailing Address - Country:US
Mailing Address - Phone:309-494-6215
Mailing Address - Fax:309-494-6214
Practice Address - Street 1:200 N GRAND AVE W
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702-2551
Practice Address - Country:US
Practice Address - Phone:309-494-6203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-28
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance