Organization
DECATUR RURAL FIRE DEPT.
Active
Other names
DECATUR VOL. FIRE AND RESCUE
Organization subpart
No
Provider details
NPI number
Authorized official
KYLEA PUNKE (RESCUE CAPTAIN)
(402) 313-9023
Entity
Organization
Contact information
Practice address
1012 S BROADWAY ST, DECATUR, NE 68020-2095
(402) 572-4019
(402) 965-8594
Mailing address
PO BOX 641880, OMAHA, NE 68164-7880
(402) 572-4019
(402) 965-8594
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09304
BLUE CROSS PROVIDER NO
—
05
—
10025095200
—
NE
01
—
1091
SQUAD LICENSE
NE
Enumeration date
10/21/2005
Last updated
02/12/2024
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