Provider Demographics
NPI:1215909411
Name:CITY OF KELLOGG
Entity type:Organization
Organization Name:CITY OF KELLOGG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPUTY CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-526-3051
Mailing Address - Street 1:417 FRONT ST.
Mailing Address - Street 2:P.O. BOX 278
Mailing Address - City:KELLOGG
Mailing Address - State:IA
Mailing Address - Zip Code:50135-0278
Mailing Address - Country:US
Mailing Address - Phone:641-526-3051
Mailing Address - Fax:
Practice Address - Street 1:417 FRONT ST
Practice Address - Street 2:
Practice Address - City:KELLOGG
Practice Address - State:IA
Practice Address - Zip Code:50135-1162
Practice Address - Country:US
Practice Address - Phone:641-526-3051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA590012456OtherMEDICARE RAILROAD
IA0170738Medicaid
0170738OtherIOWA MEDICAD ENTERPRISE
50915OtherBCBS
0170738OtherHERIT AGE JOHN DEERE
IA0170738Medicaid
IA0170738Medicaid