Provider Demographics
NPI:1780636803
Name:CITY OF DUBUQUE
Entity Type:Organization
Organization Name:CITY OF DUBUQUE
Other - Org Name:DUBUQUE FIRE & EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JANECKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-589-4194
Mailing Address - Street 1:11 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-4839
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 W 9TH ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-4839
Practice Address - Country:US
Practice Address - Phone:563-589-4194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0016782Medicaid
IA01678OtherBCBS IA
139985400OtherACS HEALTHNET
8181709OtherMEDICA
1012392OtherPHYSICIAN'S PLUS
IA0101OtherHERITAGE MA
WI81164800OtherHIRSP
000001678OtherADVOCARE MCHMO
139985400OtherWORKER'S COMPENSATION
IA0101OtherJOHN DEERE
040576OtherHEALTH ALLIANCE
41120OtherNETWORK HEALTH PLAN
WI81164800Medicaid
139985400OtherWORKER'S COMPENSATION
IA0101OtherHERITAGE MA
41120OtherNETWORK HEALTH PLAN
040576OtherHEALTH ALLIANCE
IA0101OtherHERITAGE MA