Provider Demographics
NPI:1245383181
Name:BUCKLEY FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:BUCKLEY FIRE PROTECTION DISTRICT
Other - Org Name:BUCKLEY AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LENINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-249-4888
Mailing Address - Street 1:104 E LINCOLN STREET
Mailing Address - Street 2:P.O. BOX 104
Mailing Address - City:BUCKLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60918-0104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 E LINCOLN STREET
Practice Address - Street 2:
Practice Address - City:BUCKLEY
Practice Address - State:IL
Practice Address - Zip Code:60918-0104
Practice Address - Country:US
Practice Address - Phone:217-394-2032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL6751341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL216137Medicare PIN