Healthcare Provider Details

I. General information

NPI: 1043301138
Provider Name (Legal Business Name): THE COUNTY OF THAYER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N. 4TH STREET
HEBRON NE
68370-0201
US

IV. Provider business mailing address

P.O. BOX 201
HEBRON NE
68370-0201
US

V. Phone/Fax

Practice location:
  • Phone: 402-768-6060
  • Fax: 402-768-6071
Mailing address:
  • Phone: 402-768-6060
  • Fax: 402-768-6071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1295
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateNE

VIII. Authorized Official

Name: LARRY D. HERGOTT
Title or Position: DIRECTOR
Credential: EMT
Phone: 402-768-6060