MEDICARE: BURWELL RURAL FIRE DISTRICT

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	1045	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	39434	OTHER	NE	BLUE CROSS BLUE SHIELD PR

General Provider Information

NPI Number	:	1902845084
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURWELL RURAL FIRE DISTRICT

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	:	917 'G' STREET
Second Line	:
City	:	BURWELL
State	:	NE
Zip	:	68823
Country	:	US
Telephone Number	:	402-572-4019
Fax Number	:	402-965-8594

Authorized Official
Title or Position	:	RESCUE CAPTAIN
Name	:	LINDA GROSS
Credential	:
Telephone Number	:	877-218-4392

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	02/21/2023

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Directions to “BURWELL RURAL FIRE DISTRICT ” Practice Location

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