MEDICARE: VILLAGE OF CLATONIA

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	1069	NE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590010033	OTHER	NE	RR MEDICARE PROVIDER NO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	09446	OTHER	NE	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1962464990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE OF CLATONIA

Provider Business Mailing Address
First Line	:	PO BOX 745
Second Line	:
City	:	TECUMSEH
State	:	NE
Zip	:	68450-0745
Country	:	US
Telephone Number	:	402-335-7792
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 WASHINGTON ST
Second Line	:
City	:	CLATONIA
State	:	NE
Zip	:	68328-5018
Country	:	US
Telephone Number	:	402-223-9644
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY/TREASURER
Name	:	SHANNON DENAE UHLMAN
Credential	:
Telephone Number	:	402-223-9644

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	06/19/2024

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Directions to “VILLAGE OF CLATONIA ” Practice Location

Language	Start Address	Practice Location

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