Provider Demographics
NPI:1962570507
Name:CITY OF ROCK ISLAND
Entity type:Organization
Organization Name:CITY OF ROCK ISLAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:YERKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-732-2801
Mailing Address - Street 1:1313 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-8523
Mailing Address - Country:US
Mailing Address - Phone:309-732-2800
Mailing Address - Fax:309-732-2813
Practice Address - Street 1:1313 5TH AVE
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-8523
Practice Address - Country:US
Practice Address - Phone:309-732-2800
Practice Address - Fax:309-732-2813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL02 25113416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL590003477OtherRAIL ROAD MEDICARE
IA0994988Medicaid
IL590003477OtherRAIL ROAD MEDICARE
IL590003477OtherRAIL ROAD MEDICARE