| Organization Name: | NORTHEAST IOWA MEDICAL TRANSPORT, INC. |
| NPI Number: | 1285693861 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REGINALD HENRY GROSS (CEO) |
| Mailing Address: | 704 N Vine St West Union |
| State: | IA US |
| Postal Code: | 521751018 |
| Phone Number: | 5634223723 |
| Fax Number: | 5634223723 |
| NPI Enumeration Date: | 03/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 2330400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |