1891740882 NPI number — EMERGENCY MEDICAL SERVICES PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891740882 NPI number — EMERGENCY MEDICAL SERVICES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMERGENCY MEDICAL SERVICES PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MUSCATINE MEDICAL SURGICAL ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891740882
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2104 CEDARWOOD DR
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
MUSCATINE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52761-2659
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-263-4848
Provider Business Mailing Address Fax Number:
563-263-3332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2104 CEDARWOOD DR
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
MUSCATINE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52761-2659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-263-4848
Provider Business Practice Location Address Fax Number:
563-263-3332
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ATWELL
Authorized Official First Name:
CALVIN
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
563-263-4848

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  23307 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1972574028 . This is a "CALVIN ATWELL NPI #" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1356670772 . This is a "RACHEL CREAMER" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1730150665 . This is a "MEYER NPI #" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 39496 . This is a "BCBS IA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0008132142 . This is a "BCBS IL" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 0464982 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1770632069 . This is a "BACHMAN NPI #" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1972574028 . This is a "ATWELL IL NPI#" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 1235571936 . This is a "NATE SCADLOCK" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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