Provider Demographics
NPI:1770643132
Name:CITY OF SIOUX CENTER - CITY TREASURER
Entity Type:Organization
Organization Name:CITY OF SIOUX CENTER - CITY TREASURER
Other - Org Name:CITY OF SIOUX CENTER - SIOUX CENTER AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:CHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KOOIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-722-2453
Mailing Address - Street 1:341 NORTH MAIN
Mailing Address - Street 2:
Mailing Address - City:SIOUX CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:51250-0313
Mailing Address - Country:US
Mailing Address - Phone:712-722-2453
Mailing Address - Fax:712-722-2495
Practice Address - Street 1:341 NORTH MAIN
Practice Address - Street 2:
Practice Address - City:SIOUX CENTER
Practice Address - State:IA
Practice Address - Zip Code:51250-0313
Practice Address - Country:US
Practice Address - Phone:712-722-2453
Practice Address - Fax:712-722-2495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2840400341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0211482Medicaid
IA174-72Medicare PIN
174-72Medicare UPIN