MEDICARE: CITY OF HUDSON

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	341600000X	Ambulance	2070500	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	00570	OTHER	IA	BCBS
3	590007396	OTHER	IN	RAILROAD

General Provider Information

NPI Number	:	1679645873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF HUDSON

Provider Business Mailing Address
First Line	:	525 JEFFERSON ST.
Second Line	:	P. O. BOX 712
City	:	HUDSON
State	:	IA
Zip	:	50643-9717
Country	:	US
Telephone Number	:	319-988-3322
Fax Number	:	319-988-3247

Provider Business Practice Location Address
First Line	:	200 WATERLOO RD.
Second Line	:
City	:	HUDSON
State	:	IA
Zip	:	50643-9717
Country	:	US
Telephone Number	:	319-988-3322
Fax Number	:	319-988-3247

Authorized Official
Title or Position	:	AMBULANCE CAPTAIN
Name	:	MR. LOUIE DEAN ADAMS
Credential	:	PARAMEDIC
Telephone Number	:	319-988-3322

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	06/14/2012

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Directions to “CITY OF HUDSON ” Practice Location

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