Provider Demographics
NPI:1649205469
Name:CITY OF FAYETTE
Entity Type:Organization
Organization Name:CITY OF FAYETTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/INSURANCE CLERK
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NEFZGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-425-4433
Mailing Address - Street 1:11 SOUTH MAIN
Mailing Address - Street 2:PO BOX 340
Mailing Address - City:FAYETTE
Mailing Address - State:IA
Mailing Address - Zip Code:52142-0340
Mailing Address - Country:US
Mailing Address - Phone:563-425-4433
Mailing Address - Fax:536-425-4316
Practice Address - Street 1:11 SOUTH MAIN
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:IA
Practice Address - Zip Code:52142-0340
Practice Address - Country:US
Practice Address - Phone:563-425-4433
Practice Address - Fax:563-425-4316
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF FAYETTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-11
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2330200341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance