Provider Demographics
NPI:1720140635
Name:CLAIRE FIRE & RESCUE AGENCY
Entity Type:Organization
Organization Name:CLAIRE FIRE & RESCUE AGENCY
Other - Org Name:CLARE AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-332-5335
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:CLARE
Mailing Address - State:IA
Mailing Address - Zip Code:50524-0010
Mailing Address - Country:US
Mailing Address - Phone:866-332-5335
Mailing Address - Fax:866-887-2003
Practice Address - Street 1:123 FRONT STREET
Practice Address - Street 2:
Practice Address - City:CLARE
Practice Address - State:IA
Practice Address - Zip Code:50524
Practice Address - Country:US
Practice Address - Phone:866-332-5335
Practice Address - Fax:866-887-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2010-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA29405003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0297218Medicaid
IAI8422Medicare PIN