Organization
EUSTIS RESCUE SQUAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILBERT A. KOCH (TREASURER)
(308) 486-2531
Entity
Organization
Contact information
Practice address
101 E CHANDLER ST, EUSTIS, NE 69028-0091
(308) 486-4951
Mailing address
P.O. BOX 91, 101 E CHANDLER ST, EUSTIS, NE 69028-0091
(308) 486-4951
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09418
BCBS OF NE
NE
01
—
476006180
TRICARE
—
05
—
47600618000
—
NE
Enumeration date
02/23/2007
Last updated
10/24/2008
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