Provider Demographics
NPI:1679647242
Name:COAL CITY FIRE PROTECTION DISTRICT
Entity type:Organization
Organization Name:COAL CITY FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-634-4700
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:35 S DEWITT ST
Mailing Address - City:COAL CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60416-0219
Mailing Address - Country:US
Mailing Address - Phone:815-634-4700
Mailing Address - Fax:
Practice Address - Street 1:35 S DE WITT PL
Practice Address - Street 2:
Practice Address - City:COAL CITY
Practice Address - State:IL
Practice Address - Zip Code:60416-1537
Practice Address - Country:US
Practice Address - Phone:815-634-4700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL77111341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3232006OtherBLUE CROSS BLUE SHIELD
ILP00154114OtherRAILRAOD MEDICARE
ILP00154114OtherRAILRAOD MEDICARE
IL3232006OtherBLUE CROSS BLUE SHIELD
ILX85679Medicare UPIN