Organization
LEWIS TOWNSHIP TRUSTEES
Active
Other names
Lewis Township Fire and Rescue
Organization subpart
No
Provider details
NPI number
Authorized official
JACK OCONNELL (TRUSTEE)
(712) 323-1093
Entity
Organization
Contact information
Practice address
19770 CYPRESS AVE, COUNCIL BLUFFS, IA 51503-5499
(712) 323-1093
(712) 323-9912
Mailing address
PO BOX 965, COUNCIL BLUFFS, IA 51502-0965
(712) 323-1093
(712) 323-9912
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2781300
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0414599
—
IA
05
—
10025287000
—
NE
01
—
54401
BLUE CROSS BLUE SHIELD
IA
01
—
590015633
RAILROAD MEDICARE
—
01
—
8100224
UNITED HEALTHCARE
—
Enumeration date
05/10/2006
Last updated
04/20/2008
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