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NPI 1528095056

NPI 1528095056 : FARRAGUT FIRE & RESCUE ASSOCIATION : FARRAGUT, IA

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General NPI Number Information
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    NPI Number           |    1528095056
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    Entity Type          |    Organization 
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    Legal Business Name  |    FARRAGUT FIRE & RESCUE ASSOCIATION 
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Dates
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    Enumeration Date     |    06/28/2006
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    Last Update Date     |    04/01/2008
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Provider Practice Location Address
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    Address Line         |    503 HARTFORD AVE 
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    City                 |    FARRAGUT
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    State                |    IA
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    Zip                  |    51639-2014
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    Country              |    US
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    Telephone            |    712-385-8661
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    Fax                  |    712-385-8426
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Provider Business Mailing Address
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    Address Line         |    PO BOX 60 
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    City                 |    FARRAGUT
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    State                |    IA
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    Zip                  |    51639-0060
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    Country              |    US
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    Telephone            |    712-385-8661
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    Fax                  |    712-385-8426
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Authorized Official
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    Title or Position    |    RESCUE CAPTAIN
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    Name                 |     ROBIN  SHIRLEY 
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    Credential           |    
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    Telephone            |    712-385-8319
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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       |    2360700
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    License Number State |    IA
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