Healthcare Provider Details

I. General information

NPI: 1649205469
Provider Name (Legal Business Name): CITY OF FAYETTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 SOUTH MAIN
FAYETTE IA
52142-0340
US

IV. Provider business mailing address

10802 FARNAM DR
OMAHA NE
68154-3237
US

V. Phone/Fax

Practice location:
  • Phone: 563-425-4433
  • Fax: 563-425-4316
Mailing address:
  • Phone: 531-895-5853
  • Fax: 877-343-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number2330200
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: ROGER POST
Title or Position: CREW CHIEF
Credential:
Phone: 531-895-5853