STAGE COACH MEDICAL TRANSPORT, LLC (NPI# 1427662139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427662139 |
| Entity Type | Organization |
| Organization Name | STAGE COACH MEDICAL TRANSPORT, LLC |
| Practice Address |
2202 E 48th St Davenport IA 52807-1214 |
| Practice Telephone | 5633400396 |
| Practice Fax Number | 5632718756 |
| Mailing Telephone | 5633400396 |
| Mailing Fax Number | 5632718756 |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-09-01 |
| Authorized Official Name | KELVIN D WYNN (OWNER/ CEO) |
| Authorized Official Telephone | 5763400396 |
| Is Organization Subpart | Y |
| Parent Organization Name | STAGE COACH MEDICAL TRANSPORT, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
Transportation Services |
| Street Address |
2202 E 48TH ST |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52807-1214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710455423 | Sarah Duvall | Pharmacist | 2790 East 53rd Street, Davenport, IA 52807 | 2018-11-12 |
| 1932686375 | Costco Wholesale Corporation | Hearing Aid Equipment | 2790 East 53rd St., Davenport, IA 52807 | 2018-07-27 |
| 1902258379 | Secure Dental II, LLC | Dentist | 5025 Utica Ridge Rd, Suite 103, Davenport, IA 52807 | 2016-07-08 |
| 1003288663 | Kristin Landram | Pharmacist | 4011 E 53rd Street, Davenport, IA 52807 | 2015-10-22 |
| 1912384918 | Toshia Johnson | Counselor | 3515 Spring Street, Davenport, IA 52807 | 2015-04-29 |
| 1366849440 | Dennis Aaron Brown | Counselor | 2322 E. Kimberly Rd., Ste. 200 N., Davenport, IA 52807 | 2014-12-04 |
| 1033514914 | Rachel J Staron | Counselor | 2028 E 38th St Ste 3-5, Davenport, IA 52807 | 2014-11-04 |
| 1447651518 | Anthony B. Dexter | Chiropractor | 2178 E Kimberly Rd Ste 400, Davenport, IA 52807 | 2014-09-09 |
| 1932517588 | Alan Christopher Rubach | Dentist | 3435 Spring St Ste 2, Davenport, IA 52807 | 2014-07-28 |
| 1851707459 | Allison Maxwell | Behavioral Analyst | 4959 Utica Ridge Rd, Davenport, IA 52807 | 2014-07-03 |
| Find all providers in zip 52807 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801861950 | Medic Ems | Ambulance | 1204 E High St, Davenport, IA 52803-2436 | 2006-02-22 |
| 1093955643 | Town of Davenport | Ambulance | 214 Broadway, Davenport, OK 74026-0279 | 2009-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445333 | Harpers Ferry Ems Association Inc | Ambulance | 133 North 4th St, Harpers Ferry, IA 52146-9643 | 2020-10-21 |
| 1043848237 | City of Fort Madison | Ambulance | 2335 Avenue L, Fort Madison, IA 52627-4031 | 2020-04-01 |
| 1316502826 | Coin Fire and Rescue | Ambulance | 211 First St, Coin, IA 51636-9998 | 2019-05-09 |
| 1265998942 | City of Iowa Falls | Ambulance | 217 S River St, Iowa Falls, IA 50126-2000 | 2019-02-18 |
| 1487127767 | City of Wallingford | Ambulance | 101 St. James Ave., Wallingford, IA 51365-0307 | 2019-01-09 |
| 1366915241 | Camp Twp - Polk County | Ambulance | 104 Brown St, Runnells, IA 50237-7720 | 2019-01-03 |
| 1275003402 | Westgate Fire & Rescue | Ambulance | 105 Jamison St S, Westgate, IA 50681-8640 | 2018-11-30 |
| 1861969578 | City of Centerville | Ambulance | 314 E Maple St, Centerville, IA 52544-2238 | 2018-10-31 |
| 1669984324 | City of Sioux City Accounting Division | Ambulance | 601 Douglas St, Sioux City, IA 51101-1200 | 2017-11-02 |
| 1790213478 | Exira Fire & Ems Association Incorporated | Ambulance | 2751 Highway 71, Exira, IA 50076-7648 | 2017-05-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.