Provider Demographics
NPI:1720140734
Name:CITY OF BANCROFT
Entity Type:Organization
Organization Name:CITY OF BANCROFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CITY CLERK
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-885-2382
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:BANCROFT
Mailing Address - State:IA
Mailing Address - Zip Code:50517-0157
Mailing Address - Country:US
Mailing Address - Phone:515-885-2382
Mailing Address - Fax:515-885-2383
Practice Address - Street 1:105 E RAMSEY ST
Practice Address - Street 2:
Practice Address - City:BANCROFT
Practice Address - State:IA
Practice Address - Zip Code:50517-8129
Practice Address - Country:US
Practice Address - Phone:515-885-2382
Practice Address - Fax:515-885-2383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA255083416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0137927Medicaid
IA13792Medicare ID - Type Unspecified