Healthcare Provider Details

I. General information

NPI: 1861529422
Provider Name (Legal Business Name): PAWNEE COUNTY AMBULANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 10/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 I ST
PAWNEE CITY NE
68420-0000
US

IV. Provider business mailing address

600 I ST
PAWNEE CITY NE
68420-0000
US

V. Phone/Fax

Practice location:
  • Phone: 402-852-2231
  • Fax: 402-852-2098
Mailing address:
  • Phone: 402-852-2231
  • Fax: 402-852-2098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number5129
License Number StateNE

VIII. Authorized Official

Name: DAVE L WILLIAMS
Title or Position: DIRECTOR
Credential:
Phone: 402-852-2231