Provider Demographics
NPI:1205165032
Name:BLOOMINGTON TOWNSHIP DEPARTMENT OF FIRE AND EMERGENCY SERVICES
Entity type:Organization
Organization Name:BLOOMINGTON TOWNSHIP DEPARTMENT OF FIRE AND EMERGENCY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:FARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-339-1115
Mailing Address - Street 1:5081 N OLD STATE ROAD 37
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47408-9240
Mailing Address - Country:US
Mailing Address - Phone:812-339-1115
Mailing Address - Fax:812-339-1120
Practice Address - Street 1:5081 N OLD STATE ROAD 37
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-9240
Practice Address - Country:US
Practice Address - Phone:812-339-1115
Practice Address - Fax:812-339-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0280341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance