Provider Demographics
NPI:1326048786
Name:CITY OF WALNUT
Entity Type:Organization
Organization Name:CITY OF WALNUT
Other - Org Name:WALNUT FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-784-3443
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:229 ANTIQUE CITY DRIVE
Mailing Address - City:WALNUT
Mailing Address - State:IA
Mailing Address - Zip Code:51577-0326
Mailing Address - Country:US
Mailing Address - Phone:712-784-3443
Mailing Address - Fax:712-784-3511
Practice Address - Street 1:500 PEARL ST
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:IA
Practice Address - Zip Code:51577
Practice Address - Country:US
Practice Address - Phone:712-784-3443
Practice Address - Fax:712-784-3511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-28
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27808003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0221820Medicaid
IA22182OtherBLUE CROSS PROVIDER NUMBER
22182Medicare PIN