Provider Demographics
NPI:1982665634
Name:CITY OF MECHANICSVILLE
Entity Type:Organization
Organization Name:CITY OF MECHANICSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CITY CLERK/FINANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:COPPESS
Authorized Official - Suffix:
Authorized Official - Credentials:CMC
Authorized Official - Phone:563-432-7756
Mailing Address - Street 1:100 EAST FIRST STREET
Mailing Address - Street 2:PO BOX 339
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52306
Mailing Address - Country:US
Mailing Address - Phone:563-432-7756
Mailing Address - Fax:563-432-7199
Practice Address - Street 1:100 EAST FIRST STREET
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:IA
Practice Address - Zip Code:52306
Practice Address - Country:US
Practice Address - Phone:563-432-7756
Practice Address - Fax:563-432-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21601003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0068205Medicaid
IA58634Medicare ID - Type Unspecified