Provider Demographics
NPI:1366471419
Name:TOWN OF HOSPERS
Entity Type:Organization
Organization Name:TOWN OF HOSPERS
Other - Org Name:HOSPERS AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNT REPRESENTATIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-882-9911
Mailing Address - Street 1:100 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:HOSPERS
Mailing Address - State:IA
Mailing Address - Zip Code:51238-7755
Mailing Address - Country:US
Mailing Address - Phone:605-882-9911
Mailing Address - Fax:605-882-9922
Practice Address - Street 1:100 3RD AVE S
Practice Address - Street 2:
Practice Address - City:HOSPERS
Practice Address - State:IA
Practice Address - Zip Code:51238-0248
Practice Address - Country:US
Practice Address - Phone:877-882-9911
Practice Address - Fax:877-882-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2840600341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0130575Medicaid
IA13057OtherBCBS
IA0130575Medicaid
IAD48742Medicare UPIN