Provider Demographics
NPI:1568461234
Name:ARTHUR RURAL FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:ARTHUR RURAL FIRE PROTECTION DISTRICT
Other - Org Name:ARTHUR AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:K
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:217-543-3754
Mailing Address - Street 1:323 W COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:ARTHUR
Mailing Address - State:IL
Mailing Address - Zip Code:61911-1293
Mailing Address - Country:US
Mailing Address - Phone:217-543-3754
Mailing Address - Fax:217-543-2895
Practice Address - Street 1:323 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:ARTHUR
Practice Address - State:IL
Practice Address - Zip Code:61911-1293
Practice Address - Country:US
Practice Address - Phone:217-543-3754
Practice Address - Fax:217-543-2895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL65193416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL349420Medicare ID - Type Unspecified