Healthcare Provider Details

I. General information

NPI: 1033178959
Provider Name (Legal Business Name): TOWN OF BELLEVUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 01/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 N 12TH ST
BELLEVUE IA
52031-1931
US

IV. Provider business mailing address

106 N 3RD ST
BELLEVUE IA
52031-1260
US

V. Phone/Fax

Practice location:
  • Phone: 563-872-4377
  • Fax:
Mailing address:
  • Phone: 563-872-4456
  • Fax: 563-872-4094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateIA

VIII. Authorized Official

Name: MS. CINDY ANN BLAKE
Title or Position: ASSISTANT CITY CLERK
Credential:
Phone: 563-872-4456