Bethany Fire Protection & Ambulance

Primary specialty

AmbulanceTaxonomy code 341600000X

License

6673901 Issued in IL

Legal business name

BETHANY FIRE PROTECTION & AMBULANCE

Practice address

530 E Main Street
Bethany, IL 61914

Phone

(217) 665-3726

Fax

(217) 665-3932

NPI assigned

Jun 14, 2006

Organization subpart

No

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

Authorized official

Name

Thomas Rucker

Title

Chief

Phone

(217) 665-3726

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Bethany Fire Protection District Other name

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": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1437192556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900457",
            "telephone_number": "847-577-8811",
            "fax_number": "847-577-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E MAIN STREET",
            "city": "BETHANY",
            "state": "IL",
            "postal_code": "61914",
            "telephone_number": "217-665-3726",
            "fax_number": "217-665-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY FIRE PROTECTION & AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "217-665-3726"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "6673901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "07032003",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "590015173",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethany Fire Protection District",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.