Healthcare Provider Details

I. General information

NPI: 1407845274
Provider Name (Legal Business Name): DAKOTA CITY VOLUNTEER FIRE DEPARTMENT INC. OF DAKOTA CITY, NEBRASKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 01/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 MYRTLE ST
DAKOTA CITY NE
68731
US

IV. Provider business mailing address

PO BOX 641880
OMAHA NE
68164-7880
US

V. Phone/Fax

Practice location:
  • Phone: 402-572-4019
  • Fax: 402-965-8594
Mailing address:
  • Phone: 402-572-4019
  • Fax: 402-965-8594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: PATRICK B MOORE
Title or Position: RESCUE CAPTAIN
Credential:
Phone: 402-987-3409