MEDICARE: ASHLAND RESCUE SQUAD

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	244	NE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590121423	OTHER		MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	09408	OTHER	NE	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1518916055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHLAND RESCUE SQUAD

Provider Business Mailing Address
First Line	:	PO BOX 311
Second Line	:
City	:	ASHLAND
State	:	NE
Zip	:	68003-0311
Country	:	US
Telephone Number	:	402-944-2849
Fax Number	:	402-944-7004

Provider Business Practice Location Address
First Line	:	2402 SILVER ST
Second Line	:
City	:	ASHLAND
State	:	NE
Zip	:	68003-1537
Country	:	US
Telephone Number	:	402-944-2849
Fax Number	:	402-944-7004

Authorized Official
Title or Position	:	SECRETARY/TREASURER
Name	:	PAT BOONE
Credential	:
Telephone Number	:	402-944-2849

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	05/07/2008

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Directions to “ASHLAND RESCUE SQUAD ” Practice Location

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