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General NPI Number Information
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NPI Number | 1912902818
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Entity Type | Organization
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Legal Business Name | BLAINE COUNTY RESCUE SQUAD
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 355 MANDERSON ST
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City | BREWSTER
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State | NE
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Zip | 68821-9999
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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 | 531-895-5853
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Fax | 877-343-0131
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Authorized Official
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Title or Position | CAPTAIN
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Name | CRISTIN FAY
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Credential |
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Telephone | 531-895-5853
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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 | 1035
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 1035
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License Number State | NE
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