Healthcare Provider Details

I. General information

NPI: 1487700035
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

308 PARK ST
GRINNELL IA
50112-2538
US

IV. Provider business mailing address

2535 106TH ST
URBANDALE IA
50322-3766
US

V. Phone/Fax

Practice location:
  • Phone: 515-252-1721
  • Fax: 515-252-1725
Mailing address:
  • Phone: 515-252-1721
  • Fax: 515-252-1725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number2790700
License Number StateIA

VIII. Authorized Official

Name: MR. KIM EUGENE CHAPMAN
Title or Position: PRESIDENT
Credential:
Phone: 515-252-1721