# LAWTON AMBULANCE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417968843
- **Authorized official:** MRS. MICHELE SMITH (ACCOUNT REPRESENTATIVE)
- **Authorized official phone:** (605) 882-9911

## Contact information

- **Practice address:** 104 W MAPLE, LAWTON, IA 51030
- **Practice address phone:** (877) 882-9911
- **Practice address fax:** (877) 882-9922
- **Mailing address:** PO BOX 45, LAWTON, IA 51030-0045
- **Mailing address phone:** (877) 882-9911
- **Mailing address fax:** (877) 882-9922

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 2972400 | IA | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 07/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0078196 | — | IA |
| 01 | — | 05631 | BLUE CROSS | IA |