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General NPI Number Information
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NPI Number | 1770608747
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Entity Type | Organization
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Legal Business Name | ALEXANDRIA RESCUE SERVICE
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 207 3RD STREET
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City | ALEXANDRIA
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State | NE
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Zip | 68303
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Country | US
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Telephone | 402-749-3740
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Fax |
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Provider Business Mailing Address
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Address Line | 56095 720TH RD
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City | FAIRBURY
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State | NE
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Zip | 68352-5063
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Country | US
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Telephone | 402-749-3215
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Fax |
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Authorized Official
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Title or Position | RESCUE SQUAD CAPTAIN
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Name | MARY GLENN
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Credential |
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Telephone | 402-749-3215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 1003
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License Number State | NE
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