Greene Volunteer Ambulance Service
Organization Active NPI Land Ambulance · Greene, IA
NPI 1063589554 · NPPES record last updated Sep 20, 2007
Key facts
- NPI
- 1063589554
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 2120700 (IA)
- Legal business name
- GREENE VOLUNTEER AMBULANCE SERVICE
- Practice address
- 201 North 2ND St.
Greene, IA 50636-0266 - Phone
- (641) 823-4131
- NPI assigned
- Nov 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Nancy Fiddick
- Title
- Bookkeeper
- Phone
- (641) 816-4153
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070920000250 | IA | Part B Supplier - Ambulance Service Supplier | 4183718281 | Practice locations: Greene, IA |
National Provider Directory
Locations
201 N 2nd St
Greene, IA 50636
Phone (641) 823-4131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 2120700 | IA | Yes |
Addresses
Primary practice location
201 North 2ND St.
Greene, IA 50636-0266
Mailing address
PO Box 266
Greene, IA 50636-0266
Phone (641) 823-4131
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0136408 | Medicaid | IA |
Other providers in Greene, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.