MEDICARE: NEBRASKA CITY RESCUE SERVICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	5037	NE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590015368	OTHER		RR MEDICARE PROVIDER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09492	OTHER	NE	BLUE CROSS PROVIDER

General Provider Information

NPI Number	:	1376589341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEBRASKA CITY RESCUE SERVICE

Provider Business Mailing Address
First Line	:	1409 CENTRAL AVE
Second Line	:
City	:	NEBRASKA CITY
State	:	NE
Zip	:	68410-2223
Country	:	US
Telephone Number	:	402-873-3444
Fax Number	:	402-873-5191

Provider Business Practice Location Address
First Line	:	1409 CENTRAL AVE
Second Line	:
City	:	NEBRASKA CITY
State	:	NE
Zip	:	68410-2223
Country	:	US
Telephone Number	:	402-873-3444
Fax Number	:	402-873-5191

Authorized Official
Title or Position	:	CHIEF
Name	:	JEANENE PUMMEL
Credential	:
Telephone Number	:	402-873-3444

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	06/12/2008

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Directions to “NEBRASKA CITY RESCUE SERVICE ” Practice Location

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