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General NPI Number Information
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NPI Number | 1720014517
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Entity Type | Organization
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Legal Business Name | RIVERTON VOLUNTEER FIRE AND RESCUE
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 806 SUMMER AVE
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City | RIVERTON
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State | IA
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Zip | 51650
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Country | US
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Telephone | 712-387-5212
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Fax | 712-387-5212
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Provider Business Mailing Address
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Address Line | P.O. BOX 111
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City | RIVERTON
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State | IA
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Zip | 51650
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Country | US
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Telephone | 712-387-5212
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Fax | 712-387-5212
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Authorized Official
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Title or Position | ASST. CHIEF
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Name | DOUGLAS A PHILLIPS
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Credential |
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Telephone | 712-387-3201
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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 | 2360200
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License Number State | IA
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