Provider Demographics
NPI:1164501334
Name:BLOOMFIELD AMBULANCE SERVICE
Entity type:Organization
Organization Name:BLOOMFIELD AMBULANCE SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:OBER
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:402-373-4542
Mailing Address - Street 1:PO BOX 251 211 NORTH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NE
Mailing Address - Zip Code:68718-0251
Mailing Address - Country:US
Mailing Address - Phone:402-373-4542
Mailing Address - Fax:402-373-2421
Practice Address - Street 1:211 NORTH BROADWAY
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NE
Practice Address - Zip Code:68718-0251
Practice Address - Country:US
Practice Address - Phone:402-373-4542
Practice Address - Fax:402-373-2421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5010341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100252474 00Medicaid
NE39414OtherBCBS OF NE
NE100252474 00Medicaid