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General NPI Number Information
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NPI Number | 1649223546
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Entity Type | Organization
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Legal Business Name | PEARL CITY FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 210 S MAIN ST
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City | PEARL CITY
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State | IL
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Zip | 61062-9220
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Country | US
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Telephone | 815-443-2514
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 247
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City | PEARL CITY
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State | IL
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Zip | 61062-0247
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Country | US
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Telephone | 815-443-2514
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Fax |
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Authorized Official
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Title or Position | TRUSTEE
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Name | MR. LARRY J JOHNSON
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Credential |
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Telephone | 815-443-2590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 1136501
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License Number State | ID
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