MEDICARE: GENOA RESCUE 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	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1295537330
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENOA RESCUE DEPARTMENT

Provider Business Mailing Address
First Line	:	10802 FARNAM DR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68154-3237
Country	:	US
Telephone Number	:	531-895-5853
Fax Number	:	877-343-0131

Provider Business Practice Location Address
First Line	:	514 WILLARD AVE
Second Line	:
City	:	GENOA
State	:	NE
Zip	:	68640-3039
Country	:	US
Telephone Number	:	877-218-4392
Fax Number	:	877-343-0131

Authorized Official
Title or Position	:	SECRETARY
Name	:	SHANNA TWOREK
Credential	:
Telephone Number	:	531-895-5853

Provider Enumeration Date	:	03/27/2025
Last Update Date	:	03/27/2025

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Directions to “GENOA RESCUE DEPARTMENT ” Practice Location

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