City of Montezuma
Organization Active NPI Land Ambulance · Montezuma, IA
NPI 1467548636 · NPPES record last updated Aug 13, 2012
Key facts
- NPI
- 1467548636
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 2790300 (IA)
- Legal business name
- CITY OF MONTEZUMA
- Practice address
- 503 E Main St
Montezuma, IA 50171-0314 - Phone
- (641) 623-5617
- Fax
- (641) 623-3726
- NPI assigned
- Oct 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Meryll Hicks
- Title
- City Clerk
- Phone
- (641) 623-5617
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120323000217 | IA | Part B Supplier - Ambulance Service Supplier | 5597925883 | Practice locations: Montezuma, IA |
National Provider Directory
Locations
501 E Main St
Montezuma, IA 50171
Phone (515) 623-5617
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 2790300 | IA | Yes |
Addresses
Primary practice location
503 E Main St
Montezuma, IA 50171-0314
Mailing address
503 E Main St
PO Box 314
Montezuma, IA 50171-0314
Phone (641) 623-5617
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0045310 | Medicaid | IA |
Other names
- MONTEZUMA AMBULANCE SERVICE
Other providers in Montezuma, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2012. 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.