Organization
NORTH BENTON AMBULANCE SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA JO WISE (MANAGER)
(515) 887-3553
Entity
Organization
Contact information
Practice address
704 W 4TH ST, VINTON, IA 52349-1174
(319) 472-2091
(319) 472-5629
Mailing address
704 W 4TH ST, VINTON, IA 52349-1174
(319) 472-2091
(319) 472-5629
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
2060500
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0063396
—
IA
Enumeration date
11/01/2006
Last updated
02/08/2010
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