Organization
COUNTY OF CHASE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN BEARD (ADMINISTRATOR)
(308) 882-7520
Entity
Organization
Contact information
Practice address
1233 GRANT ST, IMPERIAL, NE 69033-1299
(308) 882-7520
(308) 882-7565
Mailing address
10802 FARNAM DR, OMAHA, NE 68154-3237
(877) 218-4392
(877) 343-0131
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
1317
NE
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09379
BCBS PROVIDER NUMBER
NE
05
—
=========
—
NE
Enumeration date
06/01/2005
Last updated
09/12/2024
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