Provider Demographics
NPI:1578585931
Name:CITY OF MASON CITY
Entity Type:Organization
Organization Name:CITY OF MASON CITY
Other - Org Name:MASON CITY FIRE & RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-421-2701
Mailing Address - Street 1:10 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-3224
Mailing Address - Country:US
Mailing Address - Phone:641-421-3640
Mailing Address - Fax:641-421-2710
Practice Address - Street 1:350 5TH ST SW
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-3822
Practice Address - Country:US
Practice Address - Phone:641-421-3640
Practice Address - Fax:641-421-2710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21702003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0439794Medicaid
IA0439794Medicaid