=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932190576
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHAMBERS RURAL FIRE DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2005
-----------------------------------------------------
Last Update Date | 12/13/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 709 E MAIN ST
-----------------------------------------------------
City | CHAMBERS
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68725-5000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-218-4392
-----------------------------------------------------
Fax | 877-343-0131
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10802 FARNAM DR
-----------------------------------------------------
City | OMAHA
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68154-3237
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-218-4392
-----------------------------------------------------
Fax | 877-343-0131
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CAPTAIN
-----------------------------------------------------
Name | MR. EDWARD PAVEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 402-340-0033
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------