Organization
CITY OF EDGEWOOD
Active
Other names
Edgewood Ambulance Service
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUANE C. MILLARD PARAMEDIC SPECIALIST (AMBULANCE BILLING DIRECTOR)
(563) 928-7399
Entity
Organization
Contact information
Practice address
39245 LITTLEPORT RD, EDGEWOOD, IA 52042-8210
(563) 928-7399
Mailing address
39245 LITTLEPORT RD, EDGEWOOD, IA 52042-8210
(563) 928-7399
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2281200
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072777
—
IA
01
—
07277
WELLMARK
IA
Enumeration date
09/14/2005
Last updated
06/19/2008
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