Organization
CITY OF WAHOO
Active
Other names
WAHOO RESCUE SQUAD
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT ANDERSON (DIRECTOR OF EMS)
(402) 217-8606
Entity
Organization
Contact information
Practice address
158 W 6TH ST, WAHOO, NE 68066-1647
(877) 218-4392
(877) 343-0131
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09409
BLUE CROSS PROVIDER NO
NE
05
—
10025282400
—
NE
01
—
5138
NE. STATE LICENSE
NE
Enumeration date
10/19/2005
Last updated
04/21/2023
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