Provider Demographics
NPI:1861529422
Name:PAWNEE COUNTY AMBULANCE, INC.
Entity type:Organization
Organization Name:PAWNEE COUNTY AMBULANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-852-2231
Mailing Address - Street 1:600 I ST
Mailing Address - Street 2:
Mailing Address - City:PAWNEE CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68420-0000
Mailing Address - Country:US
Mailing Address - Phone:402-852-2231
Mailing Address - Fax:402-852-2098
Practice Address - Street 1:600 I ST
Practice Address - Street 2:
Practice Address - City:PAWNEE CITY
Practice Address - State:NE
Practice Address - Zip Code:68420-0000
Practice Address - Country:US
Practice Address - Phone:402-852-2231
Practice Address - Fax:402-852-2098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE51293416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE=========00Medicaid