Provider Demographics
NPI:1619906203
Name:TOWN OF PIERSON
Entity Type:Organization
Organization Name:TOWN OF PIERSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
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:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:PIERSON
Mailing Address - State:IA
Mailing Address - Zip Code:51048-0106
Mailing Address - Country:US
Mailing Address - Phone:712-375-5015
Mailing Address - Fax:712-375-5015
Practice Address - Street 1:514 2ND ST
Practice Address - Street 2:
Practice Address - City:PIERSON
Practice Address - State:IA
Practice Address - Zip Code:51048
Practice Address - Country:US
Practice Address - Phone:712-375-5015
Practice Address - Fax:712-375-5015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2970700341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0202283Medicaid
IA20228OtherBCBS
IA0202283Medicaid