Organization
VILLAGE OF DOUGLAS
Active
Organization
VILLAGE OF DOUGLAS
Active
Other names
DOUGLAS RESCUE
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN HARTMAN (TREASURER)
(402) 572-4019
Entity
Organization
Contact information
Practice address
104 MAIN STREET, DOUGLAS, NE 68344
(402) 572-4019
(402) 965-8594
Mailing address
1120 N RD, DOUGLAS, NE 68344-8936
(402) 572-4019
(402) 965-8594
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1098
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09350
BLUE CROSS PROVIDER NO
—
05
—
10025076200
—
NE
Enumeration date
10/24/2005
Last updated
08/22/2020
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