MEDICARE: TOWN OF CRESCENT IA

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	2718200	IA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590011831	OTHER		RR MEDICARE PROVIDER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	55282	OTHER	IA	BLUE CROSS PROVIDER IA

General Provider Information

NPI Number	:	1346310398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWN OF CRESCENT IA

Provider Business Mailing Address
First Line	:	10802 FARNAM DR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-3237
Country	:	US
Telephone Number	:	531-895-5853
Fax Number	:	877-343-0131

Provider Business Practice Location Address
First Line	:	102 W FLORENCE ST
Second Line	:
City	:	CRESCENT
State	:	IA
Zip	:	51526
Country	:	US
Telephone Number	:	402-572-4019
Fax Number	:	402-965-8594

Authorized Official
Title or Position	:	DEPUTY CHIEF
Name	:	JAMES HILL
Credential	:
Telephone Number	:	531-895-5853

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	06/11/2025

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Directions to “TOWN OF CRESCENT IA ” Practice Location

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