Provider Demographics
NPI:1699890145
Name:COUNTY OF CALHOUN
Entity type:Organization
Organization Name:COUNTY OF CALHOUN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:POHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-883-2547
Mailing Address - Street 1:FRENCH STREET
Mailing Address - Street 2:PO BOX 306
Mailing Address - City:HARDIN
Mailing Address - State:IL
Mailing Address - Zip Code:62047
Mailing Address - Country:US
Mailing Address - Phone:618-576-2288
Mailing Address - Fax:
Practice Address - Street 1:FRENCH STREET
Practice Address - Street 2:
Practice Address - City:HARDIN
Practice Address - State:IL
Practice Address - Zip Code:62047
Practice Address - Country:US
Practice Address - Phone:618-576-2288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03453341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL000357045OtherBLUE CROSS BLUE SHIELD
IL000357045OtherBLUE CROSS BLUE SHIELD
IL285630Medicare ID - Type Unspecified