Organization
CITY OF WAHOO
Active
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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