NPI Code Details Logo

NPI 1609159961

NPI 1609159961 : VILLAGE OF CLEARWATER : CLEARWATER, NE

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1609159961
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    VILLAGE OF CLEARWATER 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/23/2011
-----------------------------------------------------
    Last Update Date     |    06/30/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    628 MAIN ST 
-----------------------------------------------------
    City                 |    CLEARWATER
-----------------------------------------------------
    State                |    NE
-----------------------------------------------------
    Zip                  |    68726
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    402-485-2451
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    10802 FARNAM DR 
-----------------------------------------------------
    City                 |    OMAHA
-----------------------------------------------------
    State                |    NE
-----------------------------------------------------
    Zip                  |    68154-3237
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    531-895-5853
-----------------------------------------------------
    Fax                  |    877-343-0131
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CLERK / TREASURER
-----------------------------------------------------
    Name                 |     ANGIE W HUPP 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    531-895-5853
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    3416L0300X
-----------------------------------------------------
    Taxonomy Name        |    Land Ambulance
-----------------------------------------------------
    License Number       |    1071
-----------------------------------------------------
    License Number State |    NE
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.