1790752855 NPI number — MEAD RURAL FIRE PROTECTION DIST

Table of content: (NPI 1790752855)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790752855 NPI number — MEAD RURAL FIRE PROTECTION DIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEAD RURAL FIRE PROTECTION DIST
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:
1790752855
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 52
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEAD
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68041-0052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
24-439-6884
Provider Business Mailing Address Fax Number:
402-624-2090

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 E 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEAD
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68041-3105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-443-9688
Provider Business Practice Location Address Fax Number:
402-624-2090
Provider Enumeration Date:
03/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RAVER
Authorized Official First Name:
NICHOLAS
Authorized Official Middle Name:
D
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
402-443-9688

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10025167200 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 39466 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




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