Provider Demographics
NPI:1114197332
Name:DALE TOWNSHIP FIRE PROTECTION
Entity Type:Organization
Organization Name:DALE TOWNSHIP FIRE PROTECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-532-2232
Mailing Address - Street 1:8051 E 1100 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-6703
Mailing Address - Country:US
Mailing Address - Phone:309-379-2600
Mailing Address - Fax:309-682-5327
Practice Address - Street 1:8051 E 1100 NORTH RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-6703
Practice Address - Country:US
Practice Address - Phone:309-379-2600
Practice Address - Fax:309-682-5327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL02 25633416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport