Active NPI
Grand Junction Fire and Rescue Unit Inc
- Land Ambulance
- Grand Junction, IA
National Provider Identifier
1386677425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 2370200
- Legal business name
- GRAND JUNCTION FIRE AND RESCUE UNIT INC
- Practice address
- 109 East Main St.
Grand Junction, IA 50107 - Phone
- (515) 738-2585
- Fax
- (515) 386-8098
- NPI assigned
- Jul 9, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mark Renslow
- Title
- Rescue Captain
- Phone
- (515) 738-2585
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 2370200 | IA | Primary |
Addresses
Primary practice location
109 East Main St.
Grand Junction, IA 50107
Mailing address
109 East Main
PO Box 255
Grand Junction, IA 50107
Phone (515) 738-2585
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0485201 | Medicaid | IA | |
| 11083 | Other | IA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060127000628 | IA | Part B Supplier - Ambulance Service Supplier | 3072527100 | Practice locations: Grand Junction, IA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1386677425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 EAST MAIN",
"address_2": "PO BOX 255",
"city": "GRAND JUNCTION",
"state": "IA",
"postal_code": "50107",
"telephone_number": "515-738-2585",
"fax_number": "515-386-8098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 EAST MAIN ST.",
"city": "GRAND JUNCTION",
"state": "IA",
"postal_code": "50107",
"telephone_number": "515-738-2585",
"fax_number": "515-386-8098"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAND JUNCTION FIRE AND RESCUE UNIT INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-09",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "RENSLOW",
"authorized_official_first_name": "MARK",
"authorized_official_title_or_position": "RESCUE CAPTAIN",
"authorized_official_telephone_number": "515-738-2585",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "IA",
"license": "2370200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0485201",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "11083",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Junction, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.