JEFFERSON COUNTY AREA AMBULANCE INC (NPI# 1891855011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891855011 |
Entity Type | Organization |
Organization Name | JEFFERSON COUNTY AREA AMBULANCE INC |
Practice Address |
111 S 17th St Fairfield IA 52556-2720 |
Mailing Address |
Po Box 818 Fairfield IA 52556-0014 |
Practice Telephone | 6414722442 |
Mailing Telephone | 6414722442 |
Enumeration Date | 2006-12-11 |
Last Update Date | 2008-07-21 |
Authorized Official Name | MR. BILL LUKO (AMBULANCE OWNER-PRESIDENT) |
Authorized Official Telephone | 6419195169 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3416L0300X |
Ambulance Specialization: Land Transport |
2510200 | IA | Transportation Services |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IA | RAILROAD MEDICARE | P00248156 | 01 |
IA | 0470617 | 05 | |
IA | BCBS | 39474 | 01 |
Street Address |
111 S 17TH ST |
City | FAIRFIELD |
State | IA |
Zip Code | 52556-2720 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376175315 | Sarah Jo Chaney | Speech-Language Pathologist | 402 W Burlington Ave, Ste 200, Fairfield, IA 52556 | 2020-02-07 |
1588191290 | Kirk D. Condon | Counselor | 201 South 23rd, Fairfield, IA 52556 | 2017-05-12 |
1740644483 | Felicity Kelly | Acupuncturist | 206 E Burlington Ave #2, Fairfield, IA 52556 | 2016-04-08 |
1275964686 | Donna J Besick | Physical Therapy Assistant | 2000 S. Main St., Fairfield, IA 52556 | 2013-12-11 |
1568894731 | Mary Helen Gartin | Family Medicine | 2000c South Main, Fairfield, IA 52556 | 2013-07-30 |
1699016287 | Sarah Elizabeth Brooks | Acupuncturist | 1825 Okra Blvd, Fairfield, IA 52556 | 2013-03-07 |
1265755631 | Robert H. Schneider | Preventive Medicine | 2100 Mansion Drive, Suite 211 - Inmp, Maharishi Vedic City, IA 52556 | 2010-03-12 |
1033346127 | Madison County Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 1401 S Main St Ste 101, Fairfield, IA 52556 | 2009-06-16 |
1144490178 | Southeastern Renal Dialysis L.c. | Clinic/Center | 2000 A S Main St, Fairfield, IA 52556 | 2008-03-05 |
1497933741 | Rochelle Marie Phelps | Social Worker | 301 W. Burlington, Fairfield, IA 52556 | 2008-02-07 |
Find all providers in zip 52556 |
Taxonomy Code | 3416L0300X |
Grouping | Transportation Services |
Classification | Ambulance |
Specialization | Land Transport |
Definition to come... |
Notes: [1/1/2005: title modified] |
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Find all providers in FAIRFIELD |
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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.