Provider Demographics
NPI:1225006968
Name:CITY OF ANKENY
Entity Type:Organization
Organization Name:CITY OF ANKENY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY CHIEF OF EMS
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:PROWANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-965-6472
Mailing Address - Street 1:410 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-1557
Mailing Address - Country:US
Mailing Address - Phone:515-965-6469
Mailing Address - Fax:515-964-2107
Practice Address - Street 1:120 NW ASH DR
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-1554
Practice Address - Country:US
Practice Address - Phone:515-965-6469
Practice Address - Fax:515-964-2107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27702003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA16223OtherBLUE CROSS BLUE SHIELD IA
IA0162230Medicaid
IA16223Medicare ID - Type Unspecified
IA16223OtherBLUE CROSS BLUE SHIELD IA