NPIMap

Organization Active NPI

Lake Mills Ambulance Service

  • Land Ambulance
  • Lake Mills, IA
National Provider Identifier
1598768012
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
2950400 Issued in IA
Legal business name
LAKE MILLS AMBULANCE SERVICE
Practice address
105 S 1St Ave W
Lake Mills, IA 50450-1510
Phone
(641) 592-5772
Fax
(641) 592-4300
NPI assigned
May 30, 2005
Last updated
Dec 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Candace Kay Hanna
Title
Treasurer
Phone
(641) 592-5772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 2950400 IA Primary

Addresses

Primary practice location

105 S 1St Ave W
Lake Mills, IA 50450-1510

Mailing address

105 S 1St Ave W
Lake Mills, IA 50450-1510
Phone (641) 592-5772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101118000223 IA Part B Supplier - Ambulance Service Supplier 9032305966 Practice locations: Lake Mills, IA

National Provider Directory

National Provider Directory

Locations

105 S 1st Ave W
Lake Mills, IA 50450
Phone (641) 590-2414

NPI Registry JSON

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

{
    "created_epoch": "1117411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1598768012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S 1ST AVE W",
            "city": "LAKE MILLS",
            "state": "IA",
            "postal_code": "504501510",
            "telephone_number": "641-592-5772",
            "fax_number": "641-592-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S 1ST AVE W",
            "city": "LAKE MILLS",
            "state": "IA",
            "postal_code": "504501510",
            "telephone_number": "641-592-5772",
            "fax_number": "641-592-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MILLS AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-30",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "HANNA",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "641-592-5772",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IA",
            "license": "2950400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mills, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; 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.