Provider Demographics
NPI:1326013848
Name:MENLO COMMUNITY FIRE ASSOCIATION
Entity Type:Organization
Organization Name:MENLO COMMUNITY FIRE ASSOCIATION
Other - Org Name:MENLO FIRE AND RESCUE
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-270-1844
Mailing Address - Street 1:517 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MENLO
Mailing Address - State:IA
Mailing Address - Zip Code:50164-1002
Mailing Address - Country:US
Mailing Address - Phone:641-524-5362
Mailing Address - Fax:
Practice Address - Street 1:517 7TH ST
Practice Address - Street 2:
Practice Address - City:MENLO
Practice Address - State:IA
Practice Address - Zip Code:50164-1002
Practice Address - Country:US
Practice Address - Phone:641-524-5362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23908003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0189324Medicaid
IA49698Medicare ID - Type Unspecified