County of Greene – Land Ambulance in Jefferson, IA

Key facts

NPI: 1780148932
Entity type: Organization (NPI type 2)
Primary specialty: Land Ambulance 3416L0300X
Legal business name: COUNTY OF GREENE
Practice address: 204 N Grimmell Rd
Jefferson, IA 50129-1732
Phone: (515) 386-2136
NPI assigned: Jan 22, 2019
Organization subpart: No

Authorized official

Name: John Muir
Title: Chair
Phone: (515) 386-3101

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Lacy Rae Follett-Brubaker, D.C. Chiropractor · Jefferson, IA · NPI 1871523431

NPD

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
16D2163936	Greene County Ambulance 204 N Grimmell Rd, Jefferson, IA 50129	Certificate of waiver	Mar 24, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in IA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20190607002168	IA	Part B Supplier - Ambulance Service Supplier	8426381328	Practice locations: Jefferson, IA

National Provider Directory

Locations

204 N Grimmell Rd
Jefferson, IA 50129
Phone (515) 386-2136

204 S Chestnut St
Jefferson, IA 50129

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Land Ambulance	3416L0300X			Yes

Addresses

Primary practice location

204 N Grimmell Rd
Jefferson, IA 50129-1732

Mailing address

204 S Chestnut St
Jefferson, IA 50129-2204
Phone (515) 386-3101

Other names

Greene County Ambulance Doing business as

Other providers in Jefferson, IA

All providers in Jefferson, IA · Land Ambulance in Iowa

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2019. 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.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.