Town of Renwick

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

2460300 Issued in IA

Legal business name

TOWN OF RENWICK

Doing business as

Renwick Ambulance Service

Practice address

103 N Field St
Renwick, IA 50577

Phone

(515) 824-3511

Fax

(515) 824-3511

NPI assigned

Oct 5, 2006

Last updated

Jun 26, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melody Larson

Title

Ambulance Coordinator

Phone

(515) 824-3748

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• RENWICK AMBULANCE SERVICE Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1093801268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N FIELD ST",
            "address_2": "PO BOX 115",
            "city": "RENWICK",
            "state": "IA",
            "postal_code": "50577",
            "telephone_number": "515-824-3511",
            "fax_number": "515-824-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N FIELD ST",
            "city": "RENWICK",
            "state": "IA",
            "postal_code": "50577",
            "telephone_number": "515-824-3511",
            "fax_number": "515-824-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF RENWICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "AMBULANCE COORDINATOR",
        "authorized_official_telephone_number": "515-824-3748"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IA",
            "license": "2460300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0123109",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RENWICK AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.