Healthcare Provider Details

I. General information

NPI: 1104092535
Provider Name (Legal Business Name): BEDFORD VOLUNTEER MUNICIPAL AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 01/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 COURT AVE
BEDFORD IA
50833-1303
US

IV. Provider business mailing address

PO BOX 24
BEDFORD IA
50833-0024
US

V. Phone/Fax

Practice location:
  • Phone: 712-523-2639
  • Fax:
Mailing address:
  • Phone: 712-523-2639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number2870100
License Number StateIA

VIII. Authorized Official

Name: JEANNIE MURPHY
Title or Position: BILLING COORDINATOR
Credential:
Phone: 712-523-2639