Healthcare Provider Details

I. General information

NPI: 1285891598
Provider Name (Legal Business Name): BUFFALO CENTER VOLUNTEER AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HWY 9
BUFFALO CENTER IA
50424
US

IV. Provider business mailing address

PO BOX 437 HWY 9
BUFFALO CENTER IA
50424
US

V. Phone/Fax

Practice location:
  • Phone: 641-562-2797
  • Fax:
Mailing address:
  • Phone: 641-562-2797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number StateIA

VIII. Authorized Official

Name: MS. MARSHA KAY PETERSON
Title or Position: SEC TREAS
Credential: EMT I
Phone: 641-562-2797