Organization
THUNDERBIRD FIRE PROTECTION TERRITORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN L QUILLIAM JR. (FIRE CHIEF)
(812) 249-8196
Entity
Organization
Contact information
Practice address
104 W HEAP ST, FARMERSBURG, IN 47850
(812) 696-2151
(812) 696-2151
Mailing address
PO BOX 457, WHEELING, IL 60090-0457
(847) 577-8811
(847) 577-3518
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1075
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381756
BCBS ANTHEM
IN
Enumeration date
09/25/2006
Last updated
10/10/2007
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