Healthcare Provider Details
I. General information
NPI: 1932281292
Provider Name (Legal Business Name): CITY OF BRONSON
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
90 PINE ST
BRONSON IA
51007-0142
US
IV. Provider business mailing address
PO BOX 142
BRONSON IA
51007-0142
US
V. Phone/Fax
- Phone: 712-948-3708
- Fax:
- Phone: 712-948-3708
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 2971700 |
| License Number State | IA |
VIII. Authorized Official
Name:
MACHELE
DUNNING
Title or Position: AMBULANCE DIRECTOR
Credential:
Phone: 712-948-3708