Grand Ridge Volunteer Fire Department,Inc.

Primary specialty

AmbulanceTaxonomy code 341600000X

License

02 2534 Issued in IL

Legal business name

GRAND RIDGE VOLUNTEER FIRE DEPARTMENT,INC.

Practice address

5 E Main St
Grand Ridge, IL 61325-9122

Phone

(815) 249-5278

Fax

(815) 249-5526

NPI assigned

Feb 18, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ronald E Wilson

Title

Trustee Vice-President

Phone

(815) 651-4466

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242518400000",
    "number": "1104065911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613420260",
            "telephone_number": "815-539-2468",
            "fax_number": "815-539-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 E MAIN ST",
            "city": "GRAND RIDGE",
            "state": "IL",
            "postal_code": "613259122",
            "telephone_number": "815-249-5278",
            "fax_number": "815-249-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RIDGE VOLUNTEER FIRE DEPARTMENT,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-05-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "TRUSTEE VICE-PRESIDENT",
        "authorized_official_telephone_number": "815-651-4466",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "02 2534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald James Dean, SLP
• Cheryl Dovin, LMT, LPN
• Grand Ridge C C School Dist 95
• Carol Lynn Harcar

• Ambulance in Grand Ridge, IL
• Providers in Grand Ridge, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.