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General NPI Number Information
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NPI Number | 1033252994
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Entity Type | Organization
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Legal Business Name | TOWN OF MONDAMIN
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 602 MAPLE ST
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City | MONDAMIN
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State | IA
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Zip | 51557-2074
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Country | US
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Telephone | 402-572-4019
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Fax | 402-965-8594
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Provider Business Mailing Address
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Address Line | PO BOX 641880
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City | OMAHA
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State | NE
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Zip | 68164-7880
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Country | US
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Telephone | 402-572-4019
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Fax | 402-965-8594
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Authorized Official
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Title or Position | CAPTAIN
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Name | JEFF ANDERSON
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Credential |
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Telephone | 402-572-4019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 2430400
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License Number State | IA
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