Healthcare Provider Details

I. General information

NPI: 1447327630
Provider Name (Legal Business Name): CITY OF ROCKWELL CITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 MAIN ST
ROCKWELL CITY IA
50579-1536
US

IV. Provider business mailing address

335 MAIN ST
ROCKWELL CITY IA
50579-1536
US

V. Phone/Fax

Practice location:
  • Phone: 712-297-7041
  • Fax: 712-297-5626
Mailing address:
  • Phone: 712-297-7041
  • Fax: 712-297-5626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number2130700
License Number StateIA

VIII. Authorized Official

Name: TRAE THOMAS
Title or Position: AMBULANCE DIRECTOR
Credential:
Phone: 712-297-7199