Healthcare Provider Details

I. General information

NPI: 1518023811
Provider Name (Legal Business Name): CITY OF JEWELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 COLLINS ST
JEWELL IA
50130
US

IV. Provider business mailing address

PO BOX 399
JEWELL IA
50130-0399
US

V. Phone/Fax

Practice location:
  • Phone: 515-887-3553
  • Fax: 515-887-2000
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number24001
License Number StateIA

VIII. Authorized Official

Name: YALONDA AMONSON
Title or Position: ACCOUNT MANAGER
Credential:
Phone: 515-887-3553