Provider Demographics
NPI:1023142932
Name:LACONA FIRE AND RESCUE
Entity type:Organization
Organization Name:LACONA FIRE AND RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF OF LACONA FIRE AND RESC
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:DITTMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-534-4073
Mailing Address - Street 1:109 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LACONA
Mailing Address - State:IA
Mailing Address - Zip Code:50139-0148
Mailing Address - Country:US
Mailing Address - Phone:641-534-3444
Mailing Address - Fax:641-534-3403
Practice Address - Street 1:109 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LACONA
Practice Address - State:IA
Practice Address - Zip Code:50139-0148
Practice Address - Country:US
Practice Address - Phone:641-534-3444
Practice Address - Fax:641-534-3403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA29105003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA03982Medicare PIN