Provider Demographics
NPI:1538154323
Name:CENTER POINT AMBULANCE SERVICE INC
Entity type:Organization
Organization Name:CENTER POINT AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:TECHAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-849-3865
Mailing Address - Street 1:PO BOX 202
Mailing Address - Street 2:521 FRANKLIN STREET
Mailing Address - City:CENTER POINT
Mailing Address - State:IA
Mailing Address - Zip Code:52213-0202
Mailing Address - Country:US
Mailing Address - Phone:319-849-3865
Mailing Address - Fax:319-849-1230
Practice Address - Street 1:521 FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:IA
Practice Address - Zip Code:52213-0202
Practice Address - Country:US
Practice Address - Phone:319-849-3865
Practice Address - Fax:319-849-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-17
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA25703003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0175877Medicaid
IA03054OtherWELLMARK
IA03054Medicare PIN