Healthcare Provider Details

I. General information

NPI: 1265238596
Provider Name (Legal Business Name): GOSPER COUNTY RURAL FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 RIPLEY ST
ELWOOD NE
68937-5100
US

IV. Provider business mailing address

10802 FARNAM DR
OMAHA NE
68154-3237
US

V. Phone/Fax

Practice location:
  • Phone: 308-325-8769
  • Fax:
Mailing address:
  • Phone: 877-215-4392
  • Fax: 877-343-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JUSTIN ELLEDGE
Title or Position: RESCUE CHIEF
Credential:
Phone: 531-895-5853