1467599571 NPI number — URBANA AREA AMBULANCE SERVICE

Table of content: (NPI 1467599571)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467599571 NPI number — URBANA AREA AMBULANCE SERVICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
URBANA AREA AMBULANCE SERVICE
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:
1467599571
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 351
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
URBANA
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52345-0351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-443-3293
Provider Business Mailing Address Fax Number:
319-433-2693

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
806 WEST SUNSET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
URBANA
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
53245-9013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-443-3293
Provider Business Practice Location Address Fax Number:
319-443-2693
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GETTY
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
EDWARDS
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
319-981-9205

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  2060700 , 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: 0218610 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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