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General NPI Number Information
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NPI Number | 1174716369
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Entity Type | Organization
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Legal Business Name | CONGERVILLE RURAL FIRE DISTRICT
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 01/24/2008
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Provider Practice Location Address
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Address Line | 102 S SHARP
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City | CONGERVILLE
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State | IL
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Zip | 61729
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Country | US
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Telephone | 309-360-2338
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 85
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City | CONGERVILLE
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State | IL
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Zip | 61729
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Country | US
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Telephone | 309-360-2338
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Fax |
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | DAVE ZOBRIST
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Credential |
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Telephone | 309-360-2338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 22516
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License Number State | IL
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