Provider Demographics
NPI:1457363483
Name:DANBURY COMMUNITY AMBULANCE SERVICE
Entity Type:Organization
Organization Name:DANBURY COMMUNITY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING LIAISON
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-893-2160
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:IA
Mailing Address - Zip Code:51019-0034
Mailing Address - Country:US
Mailing Address - Phone:712-893-2160
Mailing Address - Fax:712-893-5000
Practice Address - Street 1:201 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:IA
Practice Address - Zip Code:51019-7725
Practice Address - Country:US
Practice Address - Phone:712-893-2160
Practice Address - Fax:712-893-5000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA29718003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA15719OtherBC/BS
IA0157198Medicaid
IA0157198Medicaid