Provider Demographics
NPI:1093894388
Name:CITY OF ELBERON
Entity Type:Organization
Organization Name:CITY OF ELBERON
Other - Org Name:ELBERON FIRE & RESCUE
Other - Org Type:Other Name
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KESL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-439-5306
Mailing Address - Street 1:101 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ELBERON
Mailing Address - State:IA
Mailing Address - Zip Code:52225-8717
Mailing Address - Country:US
Mailing Address - Phone:319-439-5306
Mailing Address - Fax:
Practice Address - Street 1:101 1ST ST
Practice Address - Street 2:
Practice Address - City:ELBERON
Practice Address - State:IA
Practice Address - Zip Code:52225-8717
Practice Address - Country:US
Practice Address - Phone:319-439-5306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0070698Medicaid
IA07069Medicare ID - Type UnspecifiedPROVIDER #