1649300641 NPI number — ADAIR FIRE DEPARTMENT INC

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 1649300641 NPI number — ADAIR FIRE DEPARTMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADAIR FIRE DEPARTMENT 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:
1649300641
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
505 5TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ADAIR
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-742-3241
Provider Business Mailing Address Fax Number:
641-742-3489

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505 5TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ADAIR
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50002-0036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-742-3241
Provider Business Practice Location Address Fax Number:
641-742-3489
Provider Enumeration Date:
03/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LITTLER
Authorized Official First Name:
BILL
Authorized Official Middle Name:
Authorized Official Title or Position:
AMBULANCE CAPTAIN
Authorized Official Telephone Number:
641-742-3241

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00263 . This is a "WELLMARK BC BS NUMBER" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0002634 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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