Provider Demographics
NPI:1285677450
Name:RICHMOND TOWNSHIP FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:RICHMOND TOWNSHIP FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RICH
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-678-3672
Mailing Address - Street 1:PO BOX 1053
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-2052
Mailing Address - Country:US
Mailing Address - Phone:708-478-5694
Mailing Address - Fax:
Practice Address - Street 1:5601 HUNTER DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IL
Practice Address - Zip Code:60071-4100
Practice Address - Country:US
Practice Address - Phone:815-678-3672
Practice Address - Fax:815-678-2042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71353416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL590014270OtherRR MEDICARE
IL5623100OtherBCBS
IL=========OtherTRICARE NORTH
IL693430Medicare PIN