Provider Demographics
NPI:1326208281
Name:HARMON FIRE DEPARTMENT
Entity Type:Organization
Organization Name:HARMON FIRE DEPARTMENT
Other - Org Name:HARMON FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-677-1487
Mailing Address - Street 1:275 STERLING RD
Mailing Address - Street 2:
Mailing Address - City:HARMON
Mailing Address - State:IL
Mailing Address - Zip Code:61042-9703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:275 STERLING RD
Practice Address - Street 2:
Practice Address - City:HARMON
Practice Address - State:IL
Practice Address - Zip Code:61042-9703
Practice Address - Country:US
Practice Address - Phone:815-539-2468
Practice Address - Fax:815-539-6427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01 011336341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance