Provider Demographics
NPI:1033285556
Name:NICKERSON RURAL FIRE DISTRICT
Entity Type:Organization
Organization Name:NICKERSON RURAL FIRE DISTRICT
Other - Org Name:NICKERSON VOLUNTEER FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RESCUE CAPT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:GILDOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-317-8414
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:402-965-8594
Practice Address - Street 1:112 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:NICKERSON
Practice Address - State:NE
Practice Address - Zip Code:68044
Practice Address - Country:US
Practice Address - Phone:402-572-4019
Practice Address - Fax:402-965-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12063416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEPENDINGOtherBCBS PROVIDER NUMBER
NEPENDINGMedicaid
NEPENDINGOtherBCBS PROVIDER NUMBER