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General NPI Number Information
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NPI Number | 1891787032
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Entity Type | Organization
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Legal Business Name | BRISTOL KENDALL FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 103 BEAVER ST
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City | YORKVILLE
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State | IL
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Zip | 60560-1704
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Country | US
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Telephone | 630-553-5796
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Fax | 630-553-6236
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Provider Business Mailing Address
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Address Line | 103 BEAVER ST
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City | YORKVILLE
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State | IL
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Zip | 60560-1704
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Country | US
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Telephone | 630-553-5796
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Fax | 630-553-6236
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Authorized Official
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Title or Position | ASSISTANT CHIEF
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Name | MR. TIMOTHY JOHN FAIRFIELD
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Credential |
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Telephone | 630-553-6186
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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 | 97283
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License Number State | IL
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