Organization
THOMSON FIRE PROTECTION DIST AMBULANCE ASSOCIATION
Active
Other names
Thomson Fire Protection Dist Ambulance Association
Organization subpart
No
Provider details
NPI number
Authorized official
GARY IBEN (CHIEF)
(815) 259-2027
Entity
Organization
Contact information
Practice address
910 WALNUT ST, THOMSON, IL 61285-8514
(815) 259-8255
(815) 259-8255
Mailing address
PO BOX 260, MENDOTA, IL 61342-0260
(815) 539-2468
(815) 539-6427
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1 1019
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00246725
RAILROAD MEDICARE
IL
Enumeration date
08/29/2006
Last updated
07/03/2012
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