Provider Demographics
NPI:1043848237
Name:CITY OF FORT MADISON
Entity Type:Organization
Organization Name:CITY OF FORT MADISON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-372-7700
Mailing Address - Street 1:811 AVENUE E
Mailing Address - Street 2:
Mailing Address - City:FORT MADISON
Mailing Address - State:IA
Mailing Address - Zip Code:52627-2841
Mailing Address - Country:US
Mailing Address - Phone:319-372-7700
Mailing Address - Fax:
Practice Address - Street 1:2335 AVENUE L
Practice Address - Street 2:
Practice Address - City:FORT MADISON
Practice Address - State:IA
Practice Address - Zip Code:52627-4031
Practice Address - Country:US
Practice Address - Phone:319-372-6472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport