1891740882 NPI number — EMERGENCY MEDICAL SERVICES PC

Table of content: (NPI 1891740882)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891740882 NPI number — EMERGENCY MEDICAL SERVICES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMERGENCY MEDICAL SERVICES PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MUSCATINE MEDICAL SURGICAL ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891740882
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2104 CEDARWOOD DR
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
MUSCATINE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52761-2659
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
563-263-4848
Provider Business Mailing Address Fax Number:
563-263-3332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2104 CEDARWOOD DR
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
MUSCATINE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52761-2659
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
563-263-4848
Provider Business Practice Location Address Fax Number:
563-263-3332
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ATWELL
Authorized Official First Name:
CALVIN
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
563-263-4848

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  23307 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1972574028 . This is a "CALVIN ATWELL NPI #" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1356670772 . This is a "RACHEL CREAMER" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1730150665 . This is a "MEYER NPI #" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 39496 . This is a "BCBS IA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0008132142 . This is a "BCBS IL" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 0464982 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1770632069 . This is a "BACHMAN NPI #" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1972574028 . This is a "ATWELL IL NPI#" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 1235571936 . This is a "NATE SCADLOCK" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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