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General NPI Number Information
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NPI Number | 1619139409
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Entity Type | Organization
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Legal Business Name | ATKINSON FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 101 E HENRY ST
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City | ATKINSON
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State | IL
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Zip | 61235-7713
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Country | US
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Telephone | 309-936-7220
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 140 PO BOX 140
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City | ATKINSON
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State | IL
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Zip | 61235-0140
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Country | US
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Telephone | 309-936-7979
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Fax |
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Authorized Official
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Title or Position | TRUSTEE
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Name | MARYCLAIR GUSTAFSON
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Credential |
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Telephone | 309-936-7220
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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 | 02-2517
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License Number State | IL
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