Organization
BLOOMINGTON TOWNSHIP FIRE PROTECTION DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOREN KEIM (PRESIDENT)
(309) 828-4641
Entity
Organization
Contact information
Practice address
14880 OLD COLONIAL RD, BLOOMINGTON, IL 61704-5981
(309) 828-4641
(309) 821-0206
Mailing address
14880 OLD COLONIAL RD, BLOOMINGTON, IL 61704-5981
(309) 828-4641
(309) 821-0206
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2556
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05732158
BC BS OF IL
IL
Enumeration date
08/27/2007
Last updated
03/15/2008
Update your record
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