Provider Demographics
NPI:1033430905
Name:SNOWBALL, THOMAS EDWARD SR (EMT-BASIC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:EDWARD
Last Name:SNOWBALL
Suffix:SR
Gender:M
Credentials:EMT-BASIC
Other - Prefix:
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Mailing Address - Street 1:P.O. BOX 772
Mailing Address - Street 2:504 HOCHUNK PLAZA #3
Mailing Address - City:WINNEBAGO
Mailing Address - State:NE
Mailing Address - Zip Code:68071
Mailing Address - Country:US
Mailing Address - Phone:712-204-4717
Mailing Address - Fax:
Practice Address - Street 1:100 INDIAN HILLS DRIVE
Practice Address - Street 2:OMAHA TRIBAL RESCUE 100 INDIAN HILLS DRIVE
Practice Address - City:MACY
Practice Address - State:NE
Practice Address - Zip Code:68039-0250
Practice Address - Country:US
Practice Address - Phone:402-837-5381
Practice Address - Fax:402-837-5303
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE17965146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic