Organization
ANDOVER AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCY WILCKE (RN)
(563) 244-5555
Entity
Organization
Contact information
Practice address
1367 WASHINGTON STREET, ANDOVER, IA 52701-0055
(563) 244-5555
Mailing address
PO BOX 55, ANDOVER, IA 52701-0055
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0280503
—
IA
Enumeration date
02/22/2007
Last updated
12/05/2008
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