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General NPI Number Information
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NPI Number | 1265733042
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Entity Type | Organization
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Legal Business Name | GIBBON VOULENTEER FIRE DEPARTMENT
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 714 1ST ST
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City | GIBBON
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State | NE
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Zip | 68840-6205
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Country | US
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Telephone | 308-216-1227
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Fax | 308-468-9100
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Provider Business Mailing Address
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Address Line | 714 1ST ST
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City | GIBBON
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State | NE
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Zip | 68840-6205
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Country | US
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Telephone | 308-216-1227
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Fax | 308-468-9100
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Authorized Official
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Title or Position | RESCUE CAPTAIN
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Name | CLINT SMITH
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Credential |
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Telephone | 308-216-1227
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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 | 1130
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License Number State | NE
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