Organization
CITY OF BURLINGTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW ALLEN TREXEL (CHIEF)
(319) 753-8396
Entity
Organization
Contact information
Practice address
418 VALLEY ST, BURLINGTON, IA 52601-5515
(319) 753-8396
(319) 754-9545
Mailing address
400 WASHINGTON STREET, BURLINGTON, IA 52601-5515
(319) 753-8396
(319) 754-9545
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
2290100IA
IA
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014415
—
IA
01
—
01441
WELLMARK
IA
01
—
37-1230188
ILLINOIS MEDICAID
IL
01
—
590043365
RAILROAD MEDICARE
IA
Enumeration date
02/08/2007
Last updated
05/21/2013
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