Provider Demographics
NPI:1689846248
Name:CITY OF RADCLIFFE
Entity type:Organization
Organization Name:CITY OF RADCLIFFE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CITY CLERK
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-899-2118
Mailing Address - Street 1:310 ISABELLA ST
Mailing Address - Street 2:
Mailing Address - City:RADCLIFFE
Mailing Address - State:IA
Mailing Address - Zip Code:50230-1102
Mailing Address - Country:US
Mailing Address - Phone:515-899-2118
Mailing Address - Fax:515-899-2118
Practice Address - Street 1:310 ISABELLA ST
Practice Address - Street 2:
Practice Address - City:RADCLIFFE
Practice Address - State:IA
Practice Address - Zip Code:50230-1102
Practice Address - Country:US
Practice Address - Phone:515-899-2118
Practice Address - Fax:515-899-2118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24206003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0178038Medicaid
IA0178038Medicaid