1649352402 NPI number — ARMSTRONG BENEFITED FIRE DISTRICT

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 1649352402 NPI number — ARMSTRONG BENEFITED FIRE DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARMSTRONG BENEFITED FIRE DISTRICT
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:
6
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:
1649352402
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
304 4TH AVE.
Provider Second Line Business Mailing Address:
P.O. BOX 456 HWY 9
Provider Business Mailing Address City Name:
ARMSTRONG
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50514-0456
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-362-4221
Provider Business Mailing Address Fax Number:
712-362-4221

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
304 4TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARMSTRONG
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50514-0456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-362-4221
Provider Business Practice Location Address Fax Number:
712-362-4221
Provider Enumeration Date:
10/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HAUKOOS
Authorized Official First Name:
GENE
Authorized Official Middle Name:
MELVIN
Authorized Official Title or Position:
ADMIN. DIR.
Authorized Official Telephone Number:
712-362-4221

Provider Taxonomy Codes

  • Taxonomy code: 146N00000X , with the licence number:  PS-18-018-07 , 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: 0085290 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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