# NORTH BENTON AMBULANCE SERVICE, INC.

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

## Provider details

- **NPI number:** 1457438251
- **Authorized official:** MRS. MELISSA JO WISE (MANAGER)
- **Authorized official phone:** (515) 887-3553

## Contact information

- **Practice address:** 704 W 4TH ST, VINTON, IA 52349-1174
- **Practice address phone:** (319) 472-2091
- **Practice address fax:** (319) 472-5629
- **Mailing address:** 704 W 4TH ST, VINTON, IA 52349-1174
- **Mailing address phone:** (319) 472-2091
- **Mailing address fax:** (319) 472-5629

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 2060500 | IA | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 02/08/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0063396 | — | IA |