Provider Demographics
NPI:1487127767
Name:CITY OF WALLINGFORD
Entity type:Organization
Organization Name:CITY OF WALLINGFORD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF/EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JARROD
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-867-4585
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:IA
Mailing Address - Zip Code:51365-0307
Mailing Address - Country:US
Mailing Address - Phone:712-867-4585
Mailing Address - Fax:712-867-4128
Practice Address - Street 1:101 ST. JAMES AVE.
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:IA
Practice Address - Zip Code:51365-0307
Practice Address - Country:US
Practice Address - Phone:712-867-4585
Practice Address - Fax:712-867-4128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-09
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport