Organization
LAWTON AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE SMITH (ACCOUNT REPRESENTATIVE)
(605) 882-9911
Entity
Organization
Contact information
Practice address
104 W MAPLE, LAWTON, IA 51030
(877) 882-9911
(877) 882-9922
Mailing address
PO BOX 45, LAWTON, IA 51030-0045
(877) 882-9911
(877) 882-9922
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
2972400
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0078196
—
IA
01
—
05631
BLUE CROSS
IA
Enumeration date
08/10/2006
Last updated
07/14/2008
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