Healthcare Provider Details

I. General information

NPI: 1194042788
Provider Name (Legal Business Name): WATERLOO FIRE AND RESCUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 02/24/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 7TH ST
WATERLOO NE
68069-2245
US

IV. Provider business mailing address

10802 FARNAM DR
OMAHA NE
68154-3237
US

V. Phone/Fax

Practice location:
  • Phone: 402-779-4250
  • Fax: 402-779-0841
Mailing address:
  • Phone: 877-218-4392
  • Fax: 877-343-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number5104
License Number StateNE

VIII. Authorized Official

Name: JEREMY POJAR
Title or Position: RESCUE LIEUTENANT
Credential:
Phone: 402-350-3408