Provider Demographics
NPI:1942274436
Name:TOWN OF CHURDAN
Entity Type:Organization
Organization Name:TOWN OF CHURDAN
Other - Org Name:CHURDAN FIRE AND RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:D
Authorized Official - Last Name:GEBHART
Authorized Official - Suffix:
Authorized Official - Credentials:EMTB
Authorized Official - Phone:515-389-3790
Mailing Address - Street 1:407 SAND ST
Mailing Address - Street 2:
Mailing Address - City:CHURDAN
Mailing Address - State:IA
Mailing Address - Zip Code:50050
Mailing Address - Country:US
Mailing Address - Phone:515-389-3790
Mailing Address - Fax:515-389-3334
Practice Address - Street 1:407 SAND ST
Practice Address - Street 2:
Practice Address - City:CHURDAN
Practice Address - State:IA
Practice Address - Zip Code:50050
Practice Address - Country:US
Practice Address - Phone:515-389-3790
Practice Address - Fax:515-389-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23703003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0232371Medicaid
IA590014446OtherRAILROAD MEDICARE
IA29057OtherWELLMARK BLUE CROSS
IA590014446OtherRAILROAD MEDICARE