Provider Demographics
NPI:1861779720
Name:CITY OF MEADOW GROVE
Entity type:Organization
Organization Name:CITY OF MEADOW GROVE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER/CLERK
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNEKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-634-2225
Mailing Address - Street 1:PO BOX 641880
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-7880
Mailing Address - Country:US
Mailing Address - Phone:402-572-4019
Mailing Address - Fax:402-991-0719
Practice Address - Street 1:309 MAIN ST
Practice Address - Street 2:
Practice Address - City:MEADOW GROVE
Practice Address - State:NE
Practice Address - Zip Code:68752-4126
Practice Address - Country:US
Practice Address - Phone:402-634-2345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416L0300X
NE11873416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099165Medicare PIN