1073030482 NPI number — BIG SPRINGS FIRE DISTRICT

Table of content: (NPI 1073030482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073030482 NPI number — BIG SPRINGS FIRE DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIG SPRINGS FIRE DISTRICT
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:
Provider Other Organization Name Type Code:
6
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:
1073030482
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2023
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:
877-218-4392
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 E 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIG SPRINGS
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
69122-5017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-289-0079
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/25/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ADAMS
Authorized Official First Name:
ALICIA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
308-464-1021

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  1033 , 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: 100266856-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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