Midland Ambulance Service
Organization Active NPI Land Ambulance · Wyoming, IA
NPI 1366424418 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1366424418
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 2530400 (IA)
- Legal business name
- MIDLAND AMBULANCE SERVICE
- Practice address
- 108 South Washington Street
Wyoming, IA 52362 - Phone
- (563) 488-3414
- NPI assigned
- Nov 15, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Sheila R Frink, PARAMEDIC SPECIALIST
- Title
- Billing Director
- Phone
- (319) 462-5817
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041020001101 | IA | Part B Supplier - Ambulance Service Supplier | 1759342090 | Practice locations: Wyoming, IA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 2530400 | IA | Yes |
Addresses
Primary practice location
108 South Washington Street
Wyoming, IA 52362
Mailing address
104 Broadway Place
Anamosa, IA 52205
Phone (319) 462-5817
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0072082 | Medicaid | IA |
Other providers in Wyoming, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.