Provider Demographics
NPI:1982787420
Name:CARLOCK FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:CARLOCK FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-376-3221
Mailing Address - Street 1:PO BOX 228
Mailing Address - Street 2:
Mailing Address - City:CARLOCK
Mailing Address - State:IL
Mailing Address - Zip Code:61725-0228
Mailing Address - Country:US
Mailing Address - Phone:309-376-3221
Mailing Address - Fax:309-376-2602
Practice Address - Street 1:200 NORTH LINCOLN STREET
Practice Address - Street 2:
Practice Address - City:CARLOCK
Practice Address - State:IL
Practice Address - Zip Code:61725
Practice Address - Country:US
Practice Address - Phone:309-376-3221
Practice Address - Fax:309-376-2602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2 679001341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance