Organization
CITY OF RAVENNA
Active
Other names
RAVENNA EMERGENCY UNIT
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PEGGY DETHLEFS (CAPTAIN)
(308) 379-3107
Entity
Organization
Contact information
Practice address
224 ALBA AVE, RAVENNA, NE 68869-1304
(877) 218-4392
(877) 343-0131
Mailing address
10802 FARNAM DR, OMAHA, NE 68154-3237
(531) 895-5853
(877) 343-0131
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
5107
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09360
BLUE CROSS BLUE SHIELD
NE
Enumeration date
04/05/2006
Last updated
08/14/2023
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