Manlius Fire Protection District Fire Department

Primary specialty

AmbulanceTaxonomy code 341600000X

License

01 2557 Issued in IL

Legal business name

MANLIUS FIRE PROTECTION DISTRICT FIRE DEPARTMENT

Doing business as

Manlius Ambulance

Practice address

207 E Maple
Manlius, IL 61338

Phone

(815) 866-6002

NPI assigned

Sep 5, 2008

Last updated

May 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robin B Hewitt

Title

Trustee/Treasurer

Phone

(815) 866-6602

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Manlius Ambulance Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1386892040",
    "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": "207 E MAPLE",
            "city": "MANLIUS",
            "state": "IL",
            "postal_code": "61338",
            "telephone_number": "815-866-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANLIUS FIRE PROTECTION DISTRICT FIRE DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-05",
        "last_updated": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "HEWITT",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "TRUSTEE/TREASURER",
        "authorized_official_telephone_number": "815-866-6602"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "01 2557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "---------001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manlius Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bureau Valley Unit 340
• Sherry L Desalle, FNP
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• Mullin Memorial Rural Health Services, LLC (Mullin Memorial Rural Health Clinic)

• Ambulance in Manlius, IL
• Providers in Manlius, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.