1891763793 NPI number — MINATURE VOLUNTEER FIRE DEPARTMENT

Table of content: (NPI 1891763793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891763793 NPI number — MINATURE VOLUNTEER FIRE DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MINATURE VOLUNTEER FIRE DEPARTMENT
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:
1891763793
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 165
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINATARE
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
69356-9999
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
308-635-0511
Provider Business Mailing Address Fax Number:
308-635-0164

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINATARE
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
69356-9999
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-635-0511
Provider Business Practice Location Address Fax Number:
308-635-0164
Provider Enumeration Date:
03/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EHLER
Authorized Official First Name:
LASHAE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
308-635-0511

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  1192 , 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: 590014953 . This is a "RAILROAD MEDICARE PROV#" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 39538 . This is a "BCBS PROVIDER #" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com