Provider Demographics
NPI:1285891598
Name:BUFFALO CENTER VOLUNTEER AMBULANCE
Entity type:Organization
Organization Name:BUFFALO CENTER VOLUNTEER AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SEC TREAS
Authorized Official - Prefix:MS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:EMT I
Authorized Official - Phone:641-562-2797
Mailing Address - Street 1:PO BOX 437
Mailing Address - Street 2:HWY 9
Mailing Address - City:BUFFALO CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:50424
Mailing Address - Country:US
Mailing Address - Phone:641-562-2797
Mailing Address - Fax:
Practice Address - Street 1:HWY 9
Practice Address - Street 2:
Practice Address - City:BUFFALO CENTER
Practice Address - State:IA
Practice Address - Zip Code:50424
Practice Address - Country:US
Practice Address - Phone:641-562-2797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA06350Medicare PIN