Provider Demographics
NPI:1104092535
Name:BEDFORD VOLUNTEER MUNICIPAL AMBULANCE SERVICE
Entity type:Organization
Organization Name:BEDFORD VOLUNTEER MUNICIPAL AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-523-2639
Mailing Address - Street 1:PO BOX 24
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IA
Mailing Address - Zip Code:50833-0024
Mailing Address - Country:US
Mailing Address - Phone:712-523-2639
Mailing Address - Fax:
Practice Address - Street 1:622 COURT AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IA
Practice Address - Zip Code:50833-1303
Practice Address - Country:US
Practice Address - Phone:712-523-2639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416L0300X
IA28701003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0050435Medicaid
05043Medicare PIN