Organization
FIRE PROTECTION DISTRICT 4
Active
Other names
POTTER VOLUNTEER FIRE AND RESCUE
Organization subpart
No
Provider details
NPI number
Authorized official
RAY WOTEN (CHAIRMAN)
(877) 218-4392
Entity
Organization
Contact information
Practice address
900 FRONT ST, POTTER, NE 69156
(402) 572-4019
(402) 965-8594
Mailing address
10802 FARNAM DR, OMAHA, NE 68154-3237
(877) 218-4392
(877) 343-0131
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1245
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39454
BLUE CROSS PROVIDER NO
NE
01
—
P00045115
RR MEDICARE PROVIDER NO
—
Enumeration date
08/14/2006
Last updated
02/21/2023
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