MEDICARE: SOUTHEAST IOWA AMBULANCE SERVICE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	2520400	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194729855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHEAST IOWA AMBULANCE SERVICE, INC

Provider Business Mailing Address
First Line	:	4165 NAPLES AVE SW
Second Line	:	STE 5
City	:	IOWA CITY
State	:	IA
Zip	:	52240-8624
Country	:	US
Telephone Number	:	319-466-0735
Fax Number	:	319-466-0740

Provider Business Practice Location Address
First Line	:	4165 NAPLES AVE SW
Second Line	:	STE 5
City	:	IOWA CITY
State	:	IA
Zip	:	52240-8624
Country	:	US
Telephone Number	:	319-466-0735
Fax Number	:	319-466-0740

Authorized Official
Title or Position	:	DIRECTOR/CEO
Name	:	MR. RUSSELL JOHN BAILEY
Credential	:
Telephone Number	:	319-466-0735

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	08/22/2020

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Directions to “SOUTHEAST IOWA AMBULANCE SERVICE, INC ” Practice Location

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