Provider Demographics
NPI:1780843532
Name:HEARTLAND EMS SYSTEM
Entity Type:Organization
Organization Name:HEARTLAND EMS SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:S
Authorized Official - Last Name:USKAVITCH, JR.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-582-7661
Mailing Address - Street 1:367 CEDAR CROSS RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-7730
Mailing Address - Country:US
Mailing Address - Phone:563-582-7661
Mailing Address - Fax:563-557-1576
Practice Address - Street 1:367 CEDAR CROSS RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-7730
Practice Address - Country:US
Practice Address - Phone:563-582-7661
Practice Address - Fax:563-557-1576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2310300341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance