Provider Demographics
NPI:1245334812
Name:LYNCH AREA FIRE PROTECTION DISTRICT
Entity type:Organization
Organization Name:LYNCH AREA FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HEISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-446-9038
Mailing Address - Street 1:PO BOX 641880
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-7880
Mailing Address - Country:US
Mailing Address - Phone:402-572-4019
Mailing Address - Fax:402-965-8594
Practice Address - Street 1:2315 PERRYSVILLE RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61834-9452
Practice Address - Country:US
Practice Address - Phone:217-442-0153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2327503416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00305370OtherRR MEDICARE
0009232022OtherBLUE CROSS
P00305370OtherRR MEDICARE
211045Medicare ID - Type Unspecified