Organization
FIRST CARE MEDICAL, PC
Active
Parent organization
FIRST CARE MEDICAL, PC
Other names
First Care Medical, PC of Ravenna
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIRST CARE MEDICAL, PC
Authorized official
MR. AARON J MADSEN MBA, ATC, NREMT (CLINIC ADMINISTRATOR)
(308) 236-7016
Entity
Organization
Contact information
Practice address
104 W SENECA ST, RAVENNA, NE 68869-1363
(308) 236-7016
(308) 236-7027
Mailing address
104 W SENECA ST, PO BOX 125, RAVENNA, NE 68869-1363
(308) 236-7016
(308) 236-7027
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025764700
—
NE
01
—
28D1100092
CLIA ID #
NE
01
—
DP1168
RAILROAD MEDICARE PTAN
NE
01
—
NA1259
MEDICARE PTAN
NE
Enumeration date
04/29/2009
Last updated
09/10/2015
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