MEDICARE: FOREST CITY AMBULANCE SERVICE

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	2950200	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
2	08770	OTHER	IA	BLUE CROSS

General Provider Information

NPI Number	:	1528119195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREST CITY AMBULANCE SERVICE

Provider Business Mailing Address
First Line	:	PO BOX 281
Second Line	:
City	:	FOREST CITY
State	:	IA
Zip	:	50436-0281
Country	:	US
Telephone Number	:	641-585-4634
Fax Number	:	717-635-6176

Provider Business Practice Location Address
First Line	:	105 HIGHWAY 69 SOUTH
Second Line	:
City	:	FOREST CITY
State	:	IA
Zip	:	50436-1702
Country	:	US
Telephone Number	:	641-585-4634
Fax Number	:	717-635-6176

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DALE RAYHONS
Credential	:
Telephone Number	:	641-585-4634

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	12/12/2016

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Directions to “FOREST CITY AMBULANCE SERVICE ” Practice Location

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