Provider Demographics
NPI:1346246253
Name:COUNTY OF LYON
Entity Type:Organization
Organization Name:COUNTY OF LYON
Other - Org Name:LYON COUNTY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-887-3553
Mailing Address - Street 1:206 S 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCK RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:51246-1538
Mailing Address - Country:US
Mailing Address - Phone:712-472-3713
Mailing Address - Fax:712-472-3800
Practice Address - Street 1:410 BOONE STREET
Practice Address - Street 2:
Practice Address - City:ROCK RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:51246-1538
Practice Address - Country:US
Practice Address - Phone:712-472-2521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA26001003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN333267500Medicaid
IA06728OtherBLUE CROSS BLUE SHIELD
SD9001780Medicaid
WY1214047-00Medicaid
IA0067280Medicaid
IA590010653OtherRAILROAD MEDICARE
SD9001780Medicaid