Healthcare Provider Details

I. General information

NPI: 1275578411
Provider Name (Legal Business Name): CITY OF NORWALK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 07/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 NORTH AVE
NORWALK IA
50211-1417
US

IV. Provider business mailing address

705 NORTH AVE
NORWALK IA
50211-1417
US

V. Phone/Fax

Practice location:
  • Phone: 515-962-0108
  • Fax: 515-962-0108
Mailing address:
  • Phone: 515-962-0108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number2910300
License Number StateIA

VIII. Authorized Official

Name: DUSTIN HOUSTEN
Title or Position: ASST CHIEF
Credential:
Phone: 515-962-0108