Provider Demographics
NPI:1376576918
Name:WASHINGTON VOLUNTEER FIRE DEPARTMENT AND RESCUE SQUAD INC
Entity Type:Organization
Organization Name:WASHINGTON VOLUNTEER FIRE DEPARTMENT AND RESCUE SQUAD INC
Other - Org Name:WASHINGTON FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFSTETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-444-8152
Mailing Address - Street 1:PO BOX 322
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-0322
Mailing Address - Country:US
Mailing Address - Phone:309-444-2511
Mailing Address - Fax:309-444-9532
Practice Address - Street 1:200 N WILMORE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-1249
Practice Address - Country:US
Practice Address - Phone:309-444-8642
Practice Address - Fax:309-444-7421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
IL25863416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL590001335OtherRR MEDICARE
IL9090008OtherBCBS
IL9090008OtherBCBS
IL590001335Medicare PIN