=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164567707
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOLUCA FIRE PROTECTION AND AMBULANCE DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2007
-----------------------------------------------------
Last Update Date | 09/04/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 322 W. RAILROAD
-----------------------------------------------------
City | TOLUCA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61369-0321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-452-2120
-----------------------------------------------------
Fax | 815-257-1425
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 321
-----------------------------------------------------
City | TOLUCA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61369-0321
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-452-2120
-----------------------------------------------------
Fax | 815-257-1425
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TREASURER
-----------------------------------------------------
Name | MR. RAY J. SCHUMACHER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 815-452-2120
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------