Active NPI
Allin Township Fire Protection Dist
- Land Ambulance
- Stanford, IL
National Provider Identifier
1396064697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 026525
- Legal business name
- ALLIN TOWNSHIP FIRE PROTECTION DIST
- Practice address
- 104 W Main St
Stanford, IL 61774-7540 - Phone
- (309) 379-2334
- Fax
- (309) 379-4005
- NPI assigned
- May 26, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Dustin Deterding
- Title
- EMS Chief
- Phone
- (309) 261-0101
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 026525 | IL | Primary |
Addresses
Primary practice location
104 W Main St
Stanford, IL 61774-7540
Mailing address
104 W Main St
Stanford, IL 61774-7540
Phone (309) 379-2334
Other names 1
- Allin Township Fire Protection District
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101203000877 | IL | Part B Supplier - Ambulance Service Supplier | 9335336221 | Practice locations: Stanford, IL |
National Provider Directory
National Provider Directory- Tax ID family
- Allin Township Ambulance
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ambulance
- Stanford, IL
- NPI 1407088578
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274832000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1566432000000",
"number": "1396064697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 W MAIN ST",
"city": "STANFORD",
"state": "IL",
"postal_code": "617747540",
"telephone_number": "309-379-2334",
"fax_number": "309-379-4005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 W MAIN ST",
"city": "STANFORD",
"state": "IL",
"postal_code": "617747540",
"telephone_number": "309-379-2334",
"fax_number": "309-379-4005"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALLIN TOWNSHIP FIRE PROTECTION DIST",
"organizational_subpart": "NO",
"enumeration_date": "2010-05-26",
"last_updated": "2019-08-22",
"status": "A",
"authorized_official_last_name": "DETERDING",
"authorized_official_first_name": "DUSTIN",
"authorized_official_title_or_position": "EMS CHIEF",
"authorized_official_telephone_number": "309-261-0101",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "IL",
"license": "026525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Allin Township Fire Protection District",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Stanford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.