Patoka Fire Protection District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

5 5213 Issued in IL

Legal business name

PATOKA FIRE PROTECTION DISTRICT

Doing business as

Patoka Ambulance Service

Practice address

202 West Fayette Ave
Patoka, IL 62875-1061

Phone

(618) 432-5336

Fax

(618) 432-5819

NPI assigned

Jul 17, 2006

Last updated

Aug 22, 2020By 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

Mr. R. Blake Hyde

Title

Fire Chief

Phone

(618) 432-7258

Specialties & licenses 1

Addresses

Other names 1

• Patoka Ambulance Service Doing business as

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": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477571651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 WEST FAYETTE AVE",
            "city": "PATOKA",
            "state": "IL",
            "postal_code": "628751061",
            "telephone_number": "618-432-5336",
            "fax_number": "618-432-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 WEST FAYETTE AVE",
            "city": "PATOKA",
            "state": "IL",
            "postal_code": "628751061",
            "telephone_number": "618-432-5336",
            "fax_number": "618-432-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATOKA FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HYDE",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "618-432-7258",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "5 5213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patoka Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mohammad Asghar, MD
• Patoka Cusd

• Land Ambulance in Patoka, IL
• Providers in Patoka, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.