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General NPI Number Information
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NPI Number | 1093784399
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Entity Type | Organization
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Legal Business Name | CITY OF BRIDGEPORT
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 809 MAIN ST
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City | BRIDGEPORT
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State | NE
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Zip | 69336-4046
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Country | US
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Telephone | 308-635-0511
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Fax | 308-635-0164
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Provider Business Mailing Address
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Address Line | 422 S BELTLINE HWY E
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City | SCOTTSBLUFF
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State | NE
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Zip | 69361-3501
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Country | US
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Telephone | 308-635-0511
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Fax | 308-635-0164
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Authorized Official
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Title or Position | BILLING CLERK
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Name | MR. SHAWN J BAUMGARTNER
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Credential | NREMT-P
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Telephone | 308-635-0511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 1039
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License Number State | NE
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