NPI Code Details Logo

NPI 1093896391

NPI 1093896391 : ESTHERVILLE AMBULANCE SERVICE INC. : ESTHERVILLE, IA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1093896391
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ESTHERVILLE AMBULANCE SERVICE INC. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/17/2006
-----------------------------------------------------
    Last Update Date     |    12/23/2024
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    15 N 1ST ST 
-----------------------------------------------------
    City                 |    ESTHERVILLE
-----------------------------------------------------
    State                |    IA
-----------------------------------------------------
    Zip                  |    51334-2101
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    712-362-4221
-----------------------------------------------------
    Fax                  |    712-362-4221
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    10802 FARNAM DR 
-----------------------------------------------------
    City                 |    OMAHA
-----------------------------------------------------
    State                |    NE
-----------------------------------------------------
    Zip                  |    68154-3237
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    877-218-4392
-----------------------------------------------------
    Fax                  |    877-343-0131
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    SERVICE CO - DIRECTOR
-----------------------------------------------------
    Name                 |    MR. BRAD  HELD 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    531-895-5853
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    146L00000X
-----------------------------------------------------
    Taxonomy Name        |    Paramedic
-----------------------------------------------------
    License Number       |    PS-18-018-07
-----------------------------------------------------
    License Number State |    IA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    3416L0300X
-----------------------------------------------------
    Taxonomy Name        |    Land Ambulance
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.