MEDICARE: NORTH BEND FIRE DEPARTMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	1208	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	39432	OTHER	NE	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1194865808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH BEND FIRE DEPARTMENT

Provider Business Mailing Address
First Line	:	1240 MAPLE ST
Second Line	:	PO BOX 8
City	:	NORTH BEND
State	:	NE
Zip	:	68649-4413
Country	:	US
Telephone Number	:	402-652-8161
Fax Number	:

Provider Business Practice Location Address
First Line	:	1240 MAPLE ST
Second Line	:
City	:	NORTH BEND
State	:	NE
Zip	:	68649-4413
Country	:	US
Telephone Number	:	402-652-8161
Fax Number	:

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	RICHARD GERALD KING
Credential	:
Telephone Number	:	402-652-8161

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	04/20/2008

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Directions to “NORTH BEND FIRE DEPARTMENT ” Practice Location

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