Organization
JEFFERSON COUNTY AREA AMBULANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILL LUKO (AMBULANCE OWNER-PRESIDENT)
(641) 919-5169
Entity
Organization
Contact information
Practice address
111 S 17TH ST, FAIRFIELD, IA 52556-2720
(641) 472-2442
Mailing address
PO BOX 818, FAIRFIELD, IA 52556-0014
(641) 472-2442
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2510200
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0470617
—
IA
01
—
39474
BCBS
IA
01
—
P00248156
RAILROAD MEDICARE
IA
Enumeration date
12/11/2006
Last updated
07/21/2008
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