Provider Demographics
NPI:1902008923
Name:TOWN OF MANSON AMBULANCE SERVICE
Entity Type:Organization
Organization Name:TOWN OF MANSON AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CITY CLERK
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-469-3759
Mailing Address - Street 1:1015 13TH ST
Mailing Address - Street 2:PO BOX 430
Mailing Address - City:MANSON
Mailing Address - State:IA
Mailing Address - Zip Code:50563-0430
Mailing Address - Country:US
Mailing Address - Phone:712-469-3759
Mailing Address - Fax:712-469-3076
Practice Address - Street 1:1015 13TH ST
Practice Address - Street 2:
Practice Address - City:MANSON
Practice Address - State:IA
Practice Address - Zip Code:50563-5119
Practice Address - Country:US
Practice Address - Phone:712-469-3759
Practice Address - Fax:712-469-3076
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MANSON AMBULANCE SERVICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-01
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0008029Medicaid
IA00802Medicare ID - Type Unspecified