Organization
CITY OF LAKOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE SMITH (ACCOUNT REPRESENTATIVE)
(877) 882-9911
Entity
Organization
Contact information
Practice address
205 BREWER ST, LAKOTA, IA 50451
(515) 887-3553
(515) 887-2000
Mailing address
204 1ST AVE NW, WEST BEND, IA 50597-7713
(515) 887-3553
(515) 887-2000
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2551000
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0079038
—
IA
Enumeration date
07/02/2006
Last updated
10/19/2016
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