Provider Demographics
NPI:1821145061
Name:CITY OF CUSHING
Entity Type:Organization
Organization Name:CITY OF CUSHING
Other - Org Name:CUSHING FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY CLERK
Authorized Official - Prefix:
Authorized Official - First Name:LEENETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WIESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-384-2591
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:IA
Mailing Address - Zip Code:51018-0014
Mailing Address - Country:US
Mailing Address - Phone:712-384-2591
Mailing Address - Fax:
Practice Address - Street 1:201 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:IA
Practice Address - Zip Code:51018
Practice Address - Country:US
Practice Address - Phone:712-384-2591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA29704003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA03809OtherBCBS
IA0118851Medicaid
IA03809Medicare PIN