Organization
IDA GROVE AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE SMITH (ACCOUNT REPRESENTATIVE)
(877) 882-9911
Entity
Organization
Contact information
Practice address
702 E 2ND ST, IDA GROVE, IA 51445-1613
(877) 882-9911
(877) 882-9922
Mailing address
701 E 2ND ST, IDA GROVE, IA 51445-1666
(877) 882-9911
(877) 882-9922
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2470300
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0063388
—
IA
01
—
06338
BCBS
IA
Enumeration date
06/12/2006
Last updated
07/13/2010
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