Healthcare Provider Details

I. General information

NPI: 1588720890
Provider Name (Legal Business Name): TOWN OF THOMPSON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 05/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 ADAMS ST
THOMPSON IA
50478-0196
US

IV. Provider business mailing address

PO BOX 196
THOMPSON IA
50478-0196
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 Number2950300
License Number StateIA

VIII. Authorized Official

Name: MOLLY A LEMAN
Title or Position: ACCOUNT MANAGER
Credential:
Phone: 515-887-3553