Provider Demographics
NPI:1871616128
Name:WELLMAN VOLUNTEER AMBULANCE SERVICE INC
Entity type:Organization
Organization Name:WELLMAN VOLUNTEER AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CURL
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-PS
Authorized Official - Phone:319-646-6645
Mailing Address - Street 1:95 3RD STREET
Mailing Address - Street 2:PO BOX 527
Mailing Address - City:WELLMAN
Mailing Address - State:IA
Mailing Address - Zip Code:52356-9669
Mailing Address - Country:US
Mailing Address - Phone:319-646-6645
Mailing Address - Fax:
Practice Address - Street 1:95 3RD STREET
Practice Address - Street 2:
Practice Address - City:WELLMAN
Practice Address - State:IA
Practice Address - Zip Code:52356-9669
Practice Address - Country:US
Practice Address - Phone:319-646-6645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2920500341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0129569Medicaid
IA12956Medicare ID - Type UnspecifiedMEDICARE PROVIDER