Provider Demographics
NPI:1649352402
Name:ARMSTRONG BENEFITED FIRE DISTRICT
Entity type:Organization
Organization Name:ARMSTRONG BENEFITED FIRE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN. DIR.
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:MELVIN
Authorized Official - Last Name:HAUKOOS
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT-P
Authorized Official - Phone:712-362-4221
Mailing Address - Street 1:304 4TH AVE.
Mailing Address - Street 2:P.O. BOX 456 HWY 9
Mailing Address - City:ARMSTRONG
Mailing Address - State:IA
Mailing Address - Zip Code:50514-0456
Mailing Address - Country:US
Mailing Address - Phone:712-362-4221
Mailing Address - Fax:712-362-4221
Practice Address - Street 1:304 4TH AVE
Practice Address - Street 2:
Practice Address - City:ARMSTRONG
Practice Address - State:IA
Practice Address - Zip Code:50514-0456
Practice Address - Country:US
Practice Address - Phone:712-362-4221
Practice Address - Fax:712-362-4221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAPS-18-018-07146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0085290Medicaid
IA0085290Medicaid