Provider Demographics
NPI:1093744195
Name:ANTHON COMMUNITY AMBULANCE SERVICE INCORPORATED
Entity Type:Organization
Organization Name:ANTHON COMMUNITY AMBULANCE SERVICE INCORPORATED
Other - Org Name:ANTHON RESCUE SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-898-5174
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:ANTHON
Mailing Address - State:IA
Mailing Address - Zip Code:51004-0193
Mailing Address - Country:US
Mailing Address - Phone:859-757-0565
Mailing Address - Fax:712-373-5227
Practice Address - Street 1:403 HIGHWAY 31 S.
Practice Address - Street 2:
Practice Address - City:ANTHON
Practice Address - State:IA
Practice Address - Zip Code:51004-8244
Practice Address - Country:US
Practice Address - Phone:859-757-0565
Practice Address - Fax:712-373-5227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2970100341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA07166OtherWELLMARK, BCBS
IA0027458Medicaid
IA0027458Medicaid