Provider Demographics
NPI:1528135787
Name:P.O. FIRE DISTRICT
Entity type:Organization
Organization Name:P.O. FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-669-2349
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:IL
Mailing Address - Zip Code:62275-0217
Mailing Address - Country:US
Mailing Address - Phone:618-669-2349
Mailing Address - Fax:618-669-2349
Practice Address - Street 1:#4 STATE ST.
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:IL
Practice Address - Zip Code:62275-0217
Practice Address - Country:US
Practice Address - Phone:618-669-2349
Practice Address - Fax:618-669-2349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILW25183341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL8181355OtherUNITED HEALTHCARE
IL270759OtherHEALTHLINK NETWORK
IL7301372OtherAETNA
IL332005OtherBCBS OF ILLINOIS
ILW25813OtherLICENSE NUMBER
IL7301372OtherAETNA
ILW25813OtherLICENSE NUMBER
IL7301372OtherAETNA