Provider Demographics
NPI:1275862914
Name:BLOOMINGTON FIRE DEPARTMENT
Entity Type:Organization
Organization Name:BLOOMINGTON FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY CHIEF OF ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:EASTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-349-3894
Mailing Address - Street 1:300 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47408-3505
Mailing Address - Country:US
Mailing Address - Phone:812-332-9763
Mailing Address - Fax:812-332-9764
Practice Address - Street 1:300 E 4TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-3505
Practice Address - Country:US
Practice Address - Phone:812-332-9763
Practice Address - Fax:812-332-9764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance