Healthcare Provider Details

I. General information

NPI: 1194865808
Provider Name (Legal Business Name): NORTH BEND FIRE DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 MAPLE ST
NORTH BEND NE
68649-4413
US

IV. Provider business mailing address

1240 MAPLE ST PO BOX 8
NORTH BEND NE
68649-4413
US

V. Phone/Fax

Practice location:
  • Phone: 402-652-8161
  • Fax:
Mailing address:
  • Phone: 402-652-8161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1208
License Number StateNE

VIII. Authorized Official

Name: RICHARD GERALD KING
Title or Position: FIRE CHIEF
Credential:
Phone: 402-652-8161