Provider Demographics
NPI:1669513024
Name:WASHBURN FIRE PROTECTION DISTRICT
Entity type:Organization
Organization Name:WASHBURN FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LADD
Authorized Official - Middle Name:
Authorized Official - Last Name:HARMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-253-5625
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:WASHBURN
Mailing Address - State:IL
Mailing Address - Zip Code:61570-0023
Mailing Address - Country:US
Mailing Address - Phone:309-248-7219
Mailing Address - Fax:309-248-7219
Practice Address - Street 1:207 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:WASHBURN
Practice Address - State:IL
Practice Address - Zip Code:61570
Practice Address - Country:US
Practice Address - Phone:309-248-7721
Practice Address - Fax:309-248-7219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225833416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0010270847OtherBLUE CROSS
IL0010270847OtherBLUE CROSS