1245383181 NPI number — BUCKLEY FIRE PROTECTION DISTRICT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245383181 NPI number — BUCKLEY FIRE PROTECTION DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUCKLEY FIRE PROTECTION DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245383181
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
104 E LINCOLN STREET
Provider Second Line Business Mailing Address:
P.O. BOX 104
Provider Business Mailing Address City Name:
BUCKLEY
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60918-0104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
104 E LINCOLN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUCKLEY
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60918-0104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-394-2032
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LENINGTON
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
217-249-4888

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  6751 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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