Provider Demographics
NPI:1902958150
Name:CITY OF PLEASANT HILL
Entity Type:Organization
Organization Name:CITY OF PLEASANT HILL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. CHEIF PHFD
Authorized Official - Prefix:MR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-262-9360
Mailing Address - Street 1:5151 MAPLE DR
Mailing Address - Street 2:STE 1
Mailing Address - City:PLEASANT HILL
Mailing Address - State:IA
Mailing Address - Zip Code:50327-8456
Mailing Address - Country:US
Mailing Address - Phone:515-262-9360
Mailing Address - Fax:515-262-9766
Practice Address - Street 1:5151 MAPLE DR
Practice Address - Street 2:STE 1
Practice Address - City:PLEASANT HILL
Practice Address - State:IA
Practice Address - Zip Code:50327-8456
Practice Address - Country:US
Practice Address - Phone:515-262-9360
Practice Address - Fax:515-262-9766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA77207003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0721897Medicaid
IA0721897Medicaid