Organization
NORTHEAST IOWA MEDICAL TRANSPORT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REGINALD HENRY GROSS PARAMEDIC, CRITICAL (CEO)
(563) 422-9459
Entity
Organization
Contact information
Practice address
704 N VINE ST, WEST UNION, IA 52175-1018
(563) 422-3723
(563) 422-3723
Mailing address
704 N VINE ST, WEST UNION, IA 52175-1018
(563) 422-3723
(563) 422-3723
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2330400
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0171249
—
IA
Enumeration date
03/21/2006
Last updated
08/22/2020
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