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General NPI Number Information
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NPI Number | 1083867774
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Entity Type | Organization
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Legal Business Name | VILLAGE OF BERTRAND
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 507 MINOR AVE
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City | BERTRAND
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State | NE
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Zip | 68927-3840
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Country | US
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Telephone | 308-472-3455
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 295 507 MINOR AVE
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City | BERTRAND
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State | NE
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Zip | 68927-0295
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Country | US
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Telephone | 308-472-3455
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Fax |
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Authorized Official
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Title or Position | UNIT CHIEF/UNIT CAPTAIN
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Name | MR. MONTE DEAN GREGG
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Credential |
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Telephone | 308-472-3455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 1032
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License Number State | NE
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