Provider Demographics
NPI:1720014517
Name:RIVERTON VOLUNTEER FIRE AND RESCUE
Entity Type:Organization
Organization Name:RIVERTON VOLUNTEER FIRE AND RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-387-3201
Mailing Address - Street 1:P.O. BOX 111
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:IA
Mailing Address - Zip Code:51650
Mailing Address - Country:US
Mailing Address - Phone:712-387-5212
Mailing Address - Fax:712-387-5212
Practice Address - Street 1:806 SUMMER AVE
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:IA
Practice Address - Zip Code:51650
Practice Address - Country:US
Practice Address - Phone:712-387-5212
Practice Address - Fax:712-387-5212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF RIVERTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-23
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23602003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1295Medicare PIN