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General NPI Number Information
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NPI Number | 1154463081
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Entity Type | Organization
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Legal Business Name | CHICKASAW AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 121 BUCKEYE STREET
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City | FREDERICKSBURG
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State | IA
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Zip | 50630
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Country | US
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Telephone | 563-237-6414
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Fax | 563-237-6414
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Provider Business Mailing Address
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Address Line | 121 BUCKEYE STREET
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City | FREDERICKSBURG
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State | IA
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Zip | 50630
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Country | US
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Telephone | 563-237-6414
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Fax | 563-237-6414
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES J COOK
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Credential |
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Telephone | 563-237-6414
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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 |
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License Number State |
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