=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154436822
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAYLOR TOWNSHIP FIRE DEPARTMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 NW 54TH AVE
-----------------------------------------------------
City | DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50313-1725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-289-1089
-----------------------------------------------------
Fax | 515-289-1428
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 211 NW 54TH AVE
-----------------------------------------------------
City | DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50313-1725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-289-1089
-----------------------------------------------------
Fax | 515-289-1428
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TOWNSHIP CLERK
-----------------------------------------------------
Name | MS. PHYLLIS A JONES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 515-289-1089
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0005X
-----------------------------------------------------
Taxonomy Name | Ambulatory Family Planning Facility
-----------------------------------------------------
License Number | I10464
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------