=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992768832
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TALMAGE RESCUE UNIT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2006
-----------------------------------------------------
Last Update Date | 07/31/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 MAIN STREET
-----------------------------------------------------
City | TALMAGE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-572-4019
-----------------------------------------------------
Fax | 402-965-8594
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 56
-----------------------------------------------------
City | TALMAGE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68448-0056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-325-1125
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY/TREASURER
-----------------------------------------------------
Name | WILLIAM WITTLER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 308-325-1125
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 1292
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------