Organization
CITY OF GOTHENBURG
Active
Other names
GOTHENBURG VOL. FIRE DEPT.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON WAGNER (ASST. RESCUE CAPTAIN)
(531) 895-5853
Entity
Organization
Contact information
Practice address
610 10TH ST, GOTHENBURG, NE 69138-2013
(402) 572-4019
(402) 965-8594
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
1132
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09442
BLUE CROSS BLUE SHIELD PR
NE
01
—
826590178
RAILROAD MEDICARE NO
NE
Enumeration date
04/26/2006
Last updated
10/02/2024
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