Organization
CITY OF MOLINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN LUVERNE SEDERSTROM (DEPUTY FIRE CHIEF)
(309) 524-2257
Entity
Organization
Contact information
Practice address
1630 8TH AVE, MOLINE, IL 61265-2116
(309) 524-2250
(309) 524-2270
Mailing address
1630 8TH AVENUE, MOLINE, IL 61265-2116
(309) 524-2250
(309) 524-2270
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
02253702
IL
341600000X
Ambulance
22537
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0977744
—
IA
01
—
590918082
RR MEDICARE
IL
Enumeration date
06/30/2005
Last updated
03/21/2012
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