Healthcare Provider Details

I. General information

NPI: 1932189867
Provider Name (Legal Business Name): DALLAS COUNTY IOWA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 10TH ST
PERRY IA
50220-1956
US

IV. Provider business mailing address

512 10TH ST
PERRY IA
50220-1956
US

V. Phone/Fax

Practice location:
  • Phone: 515-465-3596
  • Fax: 515-465-3596
Mailing address:
  • Phone: 515-465-3596
  • Fax: 515-465-3596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number2250200
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number2250200
License Number StateIA

VIII. Authorized Official

Name: MS. KRISTIN BRADY
Title or Position: DIRECTOR
Credential:
Phone: 515-465-3596