# SABULA AMBULANCE SERVICE

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

## Provider details

- **NPI number:** 1578684783
- **Authorized official:** DAVID LEE ACKERMAN (TREASURER)
- **Authorized official phone:** (563) 687-2432

## Contact information

- **Practice address:** 201 VULCAN STREET, SABULA, IA 52070-0303
- **Practice address phone:** (563) 687-2432
- **Practice address fax:** (563) 687-2877
- **Mailing address:** P. O. BOX 303, 201 VULCAN STREET, SABULA, IA 52070-0303
- **Mailing address phone:** (563) 687-2432
- **Mailing address fax:** (563) 687-2877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 2490400 | IA | Yes |

## Other

- **Enumeration date:** 04/03/2007
- **Last updated:** 12/10/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0064352 | — | IA |
| 01 | — | 21465 | BLUE CROSS BLUE SHIELD IA | IA |
| 01 | — | 421728331001 | ILLINOIS DEPT HEALTHCARE | IA |
| 01 | — | P00432298 | RAILROAD MEDICARE | IA |