MEDICARE: BOONE COUNTY RURAL FIRE PROTECTION DISTRICT NUMBER TWO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1346415965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOONE COUNTY RURAL FIRE PROTECTION DISTRICT NUMBER TWO

Provider Business Mailing Address
First Line	:	PO BOX 6253
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60197-6253
Country	:	US
Telephone Number	:	630-530-2988
Fax Number	:	630-832-9750

Provider Business Practice Location Address
First Line	:	1777 HENRY LUCKOW LN
Second Line	:
City	:	BELVIDERE
State	:	IL
Zip	:	61008-1702
Country	:	US
Telephone Number	:	815-544-3336
Fax Number	:	815-544-4682

Authorized Official
Title or Position	:	FINANCIAL
Name	:	BRIAN KUNCE
Credential	:
Telephone Number	:	815-544-3336

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	09/29/2023

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