1033262498 NPI number — CITY OF SPALDING

Table of content: (NPI 1033262498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033262498 NPI number — CITY OF SPALDING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF SPALDING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SPALDING RESCUE SERVICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033262498
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10802 FARNAM DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68154-3237
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
531-895-5853
Provider Business Mailing Address Fax Number:
877-343-0131

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
81843 MILL ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPALDING
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68665-6077
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-218-4392
Provider Business Practice Location Address Fax Number:
877-343-0131
Provider Enumeration Date:
01/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BAUER
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING ADMINISTRATOR
Authorized Official Telephone Number:
402-920-1620

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  1272 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 09465 . This is a "BLUE CROSS" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 591113492 . This is a "RR MEDICARE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: ========= , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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