1982683181 NPI number — PARAMOUNT EMERGENCY MEDICAL SERVICE INC

Table of content: (NPI 1982683181)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982683181 NPI number — PARAMOUNT EMERGENCY MEDICAL SERVICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARAMOUNT EMERGENCY MEDICAL SERVICE INC
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:
Provider Other Organization Name Type Code:
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:
1982683181
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5070 WOLFF RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUBUQUE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52002-2561
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-690-9222
Provider Business Mailing Address Fax Number:
563-557-8204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
285 LOCUST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUBUQUE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52001-6932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-690-9111
Provider Business Practice Location Address Fax Number:
563-557-8203
Provider Enumeration Date:
01/16/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NEY
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OFFICE MANAGER/OWNER
Authorized Official Telephone Number:
563-690-9222

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  2311100 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X , with the licence number: 6601884 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 1010 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0424432 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 35423 . This is a "WELLMARK BC & BS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 82631300 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".