Provider Demographics
NPI:1043301138
Name:THE COUNTY OF THAYER
Entity Type:Organization
Organization Name:THE COUNTY OF THAYER
Other - Org Name:THAYER COUNTY AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HERGOTT
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:402-768-6060
Mailing Address - Street 1:P.O. BOX 201
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:NE
Mailing Address - Zip Code:68370-0201
Mailing Address - Country:US
Mailing Address - Phone:402-768-6060
Mailing Address - Fax:402-768-6071
Practice Address - Street 1:225 N. 4TH STREET
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:NE
Practice Address - Zip Code:68370-0201
Practice Address - Country:US
Practice Address - Phone:402-768-6060
Practice Address - Fax:402-768-6071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1295341600000X
NE341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE590921898OtherRAILRAD MEDICARE
NEF242250OtherMIDLANDS CHOICE
NE009494OtherBLUE CROSS BLUE SHIELD
NE=========00Medicaid
NE091823Medicare Oscar/Certification
NEF242250OtherMIDLANDS CHOICE