MEDICARE: CITY OF NEBRASKA CITY

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	3416L0300X	Land Ambulance	5123	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194979831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF NEBRASKA CITY

Provider Business Mailing Address
First Line	:	1409 CENTRAL AVE
Second Line	:
City	:	NEBRASKA CITY
State	:	NE
Zip	:	68410-2223
Country	:	US
Telephone Number	:	402-873-3579
Fax Number	:	402-817-4937

Provider Business Practice Location Address
First Line	:	1409 CENTRAL AVE
Second Line	:
City	:	NEBRASKA CITY
State	:	NE
Zip	:	68410-2223
Country	:	US
Telephone Number	:	402-572-4019
Fax Number	:	402-965-8594

Authorized Official
Title or Position	:	PARAMEDIC MANAGER
Name	:	ANDREW VINCENT SNODGRASS
Credential	:
Telephone Number	:	402-873-3444

Provider Enumeration Date	:	11/07/2008
Last Update Date	:	12/12/2022

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Directions to “CITY OF NEBRASKA CITY ” Practice Location

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