Healthcare Provider Details

I. General information

NPI: 1982664215
Provider Name (Legal Business Name): CITY OF PLATTSMOUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 10/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 NORTH 5TH ST
PLATTSMOUTH NE
68048
US

IV. Provider business mailing address

136 NORTH 5TH ST
PLATTSMOUTH NE
68048
US

V. Phone/Fax

Practice location:
  • Phone: 402-572-4019
  • Fax: 402-965-8594
Mailing address:
  • Phone: 402-296-6041
  • Fax: 402-296-2391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number5115
License Number StateNE

VIII. Authorized Official

Name: MICHAEL P WOOD
Title or Position: DIRECTOR OF EMS
Credential: NREMT-P
Phone: 402-296-6041