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General NPI Number Information
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NPI Number | 1730197401
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Entity Type | Organization
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Legal Business Name | PLEASANTVILLE FIRE RESCUE
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 1012 BUSINESS HWY 5
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City | PLEASANTVILLE
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State | IA
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Zip | 50225
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Country | US
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Telephone | 515-848-5123
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Fax | 515-848-5066
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Provider Business Mailing Address
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Address Line | PO BOX 641880
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City | OMAHA
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State | NE
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Zip | 68164-7880
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Country | US
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Telephone | 402-572-4019
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Fax |
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | MR. JORDAN R VAN NESS
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Credential | PARAMEDIC
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Telephone | 641-891-2029
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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 | 2630700
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License Number State | IA
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