Provider Demographics
NPI:1598840613
Name:CITY OF KNOXVILLE
Entity Type:Organization
Organization Name:CITY OF KNOXVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-828-0550
Mailing Address - Street 1:305 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-2255
Mailing Address - Country:US
Mailing Address - Phone:641-828-0550
Mailing Address - Fax:641-828-0555
Practice Address - Street 1:305 S 3RD ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-2255
Practice Address - Country:US
Practice Address - Phone:641-828-0550
Practice Address - Fax:641-828-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA263083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA15549OtherBLUE CROSS BLUE SHIELD
IA0155499Medicaid
IA0155499Medicaid