Moulton First Responders & Volunteers Ambulance Service
Organization Active NPI Land Ambulance · Moulton, IA
NPI 1508064841 · NPPES record last updated Feb 16, 2026
Key facts
- NPI
- 1508064841
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 2040500 (IA)
- Legal business name
- MOULTON FIRST RESPONDERS & VOLUNTEERS AMBULANCE SERVICE
- Practice address
- 111 South Main
Moulton, IA 52572 - Phone
- (641) 642-3328
- NPI assigned
- Jul 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Jerilyn A. Inman, EMTP/CCP
- Title
- President
- Phone
- (641) 895-5600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070913000139 | IA | Part B Supplier - Ambulance Service Supplier | 3577657170 | Practice locations: Moulton, IA |
National Provider Directory
Locations
107 S Main St
Moulton, IA 52572
Phone (641) 642-3959
111 S Main St
Moulton, IA 52572
Phone (641) 642-3328
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 2040500 | IA | Yes |
Addresses
Primary practice location
111 South Main
Moulton, IA 52572
Mailing address
111 S Main St
Moulton, IA 52572-1327
Phone (641) 642-3328
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0245571 | Medicaid | IA |
Other names
- Moulton Volunteer Ambulance
Other providers in Moulton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2026. 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.