Provider Demographics
NPI:1275581837
Name:OUTWARD MOBILITY MEDICAL TRANSPORTATION SERVICES, INC.
Entity Type:Organization
Organization Name:OUTWARD MOBILITY MEDICAL TRANSPORTATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BONSALL
Authorized Official - Suffix:
Authorized Official - Credentials:RRT-NPS, EMT-B
Authorized Official - Phone:888-813-1639
Mailing Address - Street 1:31 W IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:IA
Mailing Address - Zip Code:51529-1559
Mailing Address - Country:US
Mailing Address - Phone:888-813-1639
Mailing Address - Fax:712-643-5661
Practice Address - Street 1:31 W IOWA AVE
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:IA
Practice Address - Zip Code:51529-1559
Practice Address - Country:US
Practice Address - Phone:888-813-1639
Practice Address - Fax:712-643-5661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24308003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0159202Medicaid
IA0159202Medicaid