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General NPI Number Information
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NPI Number | 1295884708
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Entity Type | Organization
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Legal Business Name | MACKINAW FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 104 W MADISON
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City | MACKINAW
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State | IL
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Zip | 61755
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Country | US
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Telephone | 309-359-3571
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Fax |
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Provider Business Mailing Address
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Address Line | 104 W MADISON
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City | MACKINAW
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State | IL
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Zip | 61755
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Country | US
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Telephone | 309-359-3571
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Fax |
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Authorized Official
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Title or Position | SECRETARY TREASURER
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Name | MRS. MARION LEE JACOBS
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Credential |
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Telephone | 309-359-3571
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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 | 2259301
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 22593
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License Number State | IL
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