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Organization

CITY OF PERU

Active
Other names
PERU RESCUE SQUAD
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRENT E LOTTMAN (RESCUE CAPTAIN)
(402) 572-4019
Entity
Organization

Contact information

Practice address
518 5TH STREET, PERU, NE 68421
(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
3416L0300X
Land Ambulance
Primary
1232
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09333
BLUE CROSS BLUE SHIELD
NE
Enumeration date
06/08/2007
Last updated
04/20/2008
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