1972502490 NPI number — CITY OF DODGE

Table of content: (NPI 1972502490)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972502490 NPI number — CITY OF DODGE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF DODGE
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:
DODGE RESCUE UNIT
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:
1972502490
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2024
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:
233 N. OAK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DODGE
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68633-0013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-693-2274
Provider Business Practice Location Address Fax Number:
402-693-2318
Provider Enumeration Date:
07/18/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LANGHORST
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICER-TREASURER FINANCIAL
Authorized Official Telephone Number:
402-459-1473

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  1096 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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