Waterville Fire Dept Squad

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

WATERVILLE FIRE DEPT SQUAD

Doing business as

Waterville Ambulance Service

Practice address

121 Main St
Waterville, IA 52170-7521

Phone

(563) 568-7347

NPI assigned

Nov 5, 2020

Last updated

Nov 5, 2020By 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

Loren J Mitchell

Title

Vice President

Phone

(563) 568-7347

Specialties & licenses 1

Addresses

Other names 1

• Waterville Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1285235275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641880",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681647880",
            "telephone_number": "402-572-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 MAIN ST",
            "city": "WATERVILLE",
            "state": "IA",
            "postal_code": "521707521",
            "telephone_number": "563-568-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERVILLE FIRE DEPT SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "LOREN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "563-568-7347"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterville Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Waterville Ambulance Services
• Waterville Fire Dept Volunteer Rescue Squad

• Land Ambulance in Waterville, IA
• Providers in Waterville, IA by specialty
• Land Ambulance in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.