# HARLEM ROSCOE FIRE PROTECTION DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Harlem Roscoe Ambulance Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518087436
- **Authorized official:** DONALD SHOEVLIN (CHIEF)
- **Authorized official phone:** (815) 623-7867

## Contact information

- **Practice address:** 10544 MAIN ST, ROSCOE, IL 61073-8829
- **Practice address phone:** (815) 623-7867
- **Practice address fax:** (815) 623-8831
- **Mailing address:** 10544 MAIN ST, PO BOX 450, ROSCOE, IL 61073-0450
- **Mailing address phone:** (815) 623-7867
- **Mailing address fax:** (815) 623-8831

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 01/24/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 381320 | MEDICARE | — |