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NPI Code Detail

MEDICARE: MR. RONALD JAMES FREEMONT JR. NREMT I

MEDICARE: MR. RONALD JAMES FREEMONT JR. NREMT I
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
1146M00000XIntermediate Emergency Medical Technician2859NE
2146M00000XIntermediate Emergency Medical TechnicianI-12-317-12IA

General Provider Information

NPI Number : 1558680207
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RONALD JAMES FREEMONT JR. NREMT I
Provider Business Mailing Address
First Line : 430 W 11TH ST
Second Line : PO BOX 172
City : DECATUR
State : NE
Zip : 68020-2093
Country : US
Telephone Number : 402-870-0851
Fax Number :
Provider Business Practice Location Address
First Line : 100 INDIAN HILLS DR
Second Line :
City : MACY
State : NE
Zip : 68039-3023
Country : US
Telephone Number : 402-870-0851
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2010
Last Update Date : 05/20/2010

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