Healthcare Provider Details

I. General information

NPI: 1669461653
Provider Name (Legal Business Name): DECATUR RURAL FIRE DEPT.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 S BROADWAY ST
DECATUR NE
68020-2095
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 TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: KYLEA PUNKE
Title or Position: RESCUE CAPTAIN
Credential:
Phone: 402-313-9023