Provider Demographics
NPI:1407079452
Name:ORION FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:ORION FIRE PROTECTION DISTRICT
Other - Org Name:ORION VOLUNTEER AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TRUSTEE
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BORDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-756-8550
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:ORION
Mailing Address - State:IL
Mailing Address - Zip Code:61273-0236
Mailing Address - Country:US
Mailing Address - Phone:309-526-3365
Mailing Address - Fax:
Practice Address - Street 1:501 11TH AVE
Practice Address - Street 2:
Practice Address - City:ORION
Practice Address - State:IL
Practice Address - Zip Code:61273-7773
Practice Address - Country:US
Practice Address - Phone:309-526-3365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL22545341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========002Medicaid
IL260790Medicare ID - Type UnspecifiedMEDICARE
IL=========002Medicaid