1922351386 NPI number — MALTA FIRE PROTECTION DISTRICT

Table of content: (NPI 1922351386)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922351386 NPI number — MALTA FIRE PROTECTION DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MALTA 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:
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:
1922351386
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/23/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 457
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHEELING
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60090-0457
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-577-8811
Provider Business Mailing Address Fax Number:
847-577-3518

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MALTA
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60150-9738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-825-2067
Provider Business Practice Location Address Fax Number:
815-825-1067
Provider Enumeration Date:
10/23/2012

Additional Information

Authorized Official

Authorized Official Last Name:
BYERHOF
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
815-761-2940

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  101401 , 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)





Copyright © 2007-2025 www.npivalidator.com