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General NPI Number Information
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NPI Number | 1508826538
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Entity Type | Organization
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Legal Business Name | CITY OF PONCA
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 111 S NEBRASKA ST
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City | PONCA
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State | NE
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Zip | 68770-7286
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Country | US
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Telephone | 877-218-4392
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Fax | 877-343-0131
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Provider Business Mailing Address
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Address Line | 10802 FARNAM DR
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City | OMAHA
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State | NE
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Zip | 68154-3237
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Country | US
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Telephone | 877-218-4392
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Fax | 877-343-0131
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Authorized Official
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Title or Position | RESCUE CAPTAIN
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Name | JESS KASTNING
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Credential |
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Telephone | 877-218-4392
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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 | 1244
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License Number State | NE
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