Healthcare Provider Details

I. General information

NPI: 1972585966
Provider Name (Legal Business Name): ANAMOSA AREA AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 GRANT WOOD DR
ANAMOSA IA
52205-0000
US

IV. Provider business mailing address

101 GRANT WOOD DR
ANAMOSA IA
52205-2117
US

V. Phone/Fax

Practice location:
  • Phone: 319-481-6409
  • Fax: 319-481-6339
Mailing address:
  • Phone: 319-481-6409
  • Fax: 319-481-6339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number2530100
License Number StateIA

VIII. Authorized Official

Name: MRS. SHEILA R FRINK
Title or Position: DIRECTOR
Credential: PARAMEDIC SPECIALIST
Phone: 319-462-5817