Provider Demographics
NPI:1467514422
Name:CITY OF CARSON
Entity Type:Organization
Organization Name:CITY OF CARSON
Other - Org Name:CARSON FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY CLERK
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-484-3636
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:IA
Mailing Address - Zip Code:51525-0128
Mailing Address - Country:US
Mailing Address - Phone:712-484-3636
Mailing Address - Fax:712-484-3645
Practice Address - Street 1:127 BROADWAY
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:IA
Practice Address - Zip Code:51525
Practice Address - Country:US
Practice Address - Phone:866-332-5335
Practice Address - Fax:866-887-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27814003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0452433Medicaid
IA0452433Medicaid