Healthcare Provider Details
I. General information
NPI: 1225184864
Provider Name (Legal Business Name): MIDWEST AMBULANCE SERVICE OF IOWA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/26/2007
Last Update Date: 09/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1229 OHIO ST
DES MOINES IA
50314-3116
US
IV. Provider business mailing address
2535 106TH ST
DES MOINES IA
50322-3766
US
V. Phone/Fax
- Phone: 515-244-0409
- Fax: 515-243-4932
- Phone: 515-252-1721
- Fax: 515-252-1725
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 2772000 |
| License Number State | IA |
VIII. Authorized Official
Name: MR.
KIM
EUGENE
CHAPMAN
Title or Position: PRESIDENT
Credential:
Phone: 515-252-1721