=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619947199
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CITY OF INDIANOLA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/25/2006
-----------------------------------------------------
Last Update Date | 07/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 110 NORTH 1ST ST.
-----------------------------------------------------
City | INDIANOLA
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50125
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-961-9405
-----------------------------------------------------
Fax | 515-962-0108
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 299 110 N FIRST
-----------------------------------------------------
City | INDIANOLA
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50125-0299
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-961-9405
-----------------------------------------------------
Fax | 515-962-0108
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF
-----------------------------------------------------
Name | AARON DOUGLAS HURT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 515-962-5257
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 29107
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 2910700
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------