Organization
ATKINSON FIRE PROTECTION DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYCLAIR GUSTAFSON (TRUSTEE)
(309) 936-7220
Entity
Organization
Contact information
Practice address
101 E HENRY ST, ATKINSON, IL 61235-7713
(309) 936-7220
Mailing address
PO BOX 140, PO BOX 140, ATKINSON, IL 61235-0140
(309) 936-7979
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
02-2517
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
942930
MEDICARE PROVIDER
IL
Enumeration date
07/02/2008
Last updated
06/11/2013
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