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General NPI Number Information
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NPI Number | 1962713495
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Entity Type | Organization
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Legal Business Name | COAL VALLEY FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 103 W 18TH AVE
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City | COAL VALLEY
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State | IL
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Zip | 61240
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Country | US
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Telephone | 309-799-5534
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Fax | 309-799-8446
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Provider Business Mailing Address
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Address Line | 103 W 18TH AVE
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City | COAL VALLEY
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State | IL
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Zip | 61240-9337
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Country | US
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Telephone | 309-799-5534
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Fax | 309-799-8446
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | DAVID E DUNHAM JR.
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Credential |
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Telephone | 309-799-5534
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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 |
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License Number State |
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