MEDICARE: RISING CITY RURAL FIRE DIST NO 3

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	1456	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	:	1265891444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RISING CITY RURAL FIRE DIST NO 3

Provider Business Mailing Address
First Line	:	10802 FARNAM DR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-3237
Country	:	US
Telephone Number	:	877-218-4392
Fax Number	:	877-343-0131

Provider Business Practice Location Address
First Line	:	105 MAIN ST
Second Line	:
City	:	RISING CITY
State	:	NE
Zip	:	68658
Country	:	US
Telephone Number	:	402-542-2430
Fax Number	:	402-542-2130

Authorized Official
Title or Position	:	TREASURER
Name	:	MR. KENDALL A POTTER
Credential	:
Telephone Number	:	402-641-0392

Provider Enumeration Date	:	02/17/2016
Last Update Date	:	02/24/2023

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