Healthcare Provider Details

I. General information

NPI: 1609869304
Provider Name (Legal Business Name): CROFTON VOLUNTEER AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 06/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W WYOMING ST
CROFTON NE
68730-3200
US

IV. Provider business mailing address

204 W WYOMING ST
CROFTON NE
68730-3200
US

V. Phone/Fax

Practice location:
  • Phone: 402-388-4110
  • Fax: 402-388-4579
Mailing address:
  • Phone: 402-388-4110
  • Fax: 402-388-4579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MS. BARBARA A ZAVADIL
Title or Position: BOOKKEEPER
Credential:
Phone: 402-388-4110