Healthcare Provider Details

I. General information

NPI: 1093744195
Provider Name (Legal Business Name): ANTHON COMMUNITY AMBULANCE SERVICE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 HIGHWAY 31 S.
ANTHON IA
51004-8244
US

IV. Provider business mailing address

PO BOX 193
ANTHON IA
51004-0193
US

V. Phone/Fax

Practice location:
  • Phone: 859-757-0565
  • Fax: 712-373-5227
Mailing address:
  • Phone: 859-757-0565
  • Fax: 712-373-5227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number2970100
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number2970100
License Number StateIA

VIII. Authorized Official

Name: LORI HANDKE
Title or Position: TREASURER
Credential:
Phone: 712-898-5174