Healthcare Provider Details

I. General information

NPI: 1871958462
Provider Name (Legal Business Name): CROFTON COMMUNITY FIRE PROTECTION DIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W IOWA ST
CROFTON NE
68730-4143
US

IV. Provider business mailing address

55153 895 RD
CROFTON NE
68730-3206
US

V. Phone/Fax

Practice location:
  • Phone: 402-388-4635
  • Fax: 402-388-4635
Mailing address:
  • Phone: 402-388-4187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1084
License Number StateNE

VIII. Authorized Official

Name: DUANE GUENTHER
Title or Position: SECRETARY/TREASURER
Credential:
Phone: 402-388-4187