Provider Demographics
NPI:1649247099
Name:CITY OF MUSCATINE
Entity type:Organization
Organization Name:CITY OF MUSCATINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MUSCATINE FIRE DEPT.
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:EWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-263-9233
Mailing Address - Street 1:312 E 5TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-4214
Mailing Address - Country:US
Mailing Address - Phone:563-263-9233
Mailing Address - Fax:563-263-5534
Practice Address - Street 1:312 E 5TH ST STE 2
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-4214
Practice Address - Country:US
Practice Address - Phone:563-263-9233
Practice Address - Fax:563-263-5534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2 25153416L0300X
IA27002003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0211391Medicaid
FL205148500OtherACS - DEPT. OF LABOR
IA22364OtherWELLMARK BC/BS
IA0211391Medicaid
IA22364OtherWELLMARK BC/BS
IL=========001Medicaid