Provider Demographics
NPI:1093856148
Name:CITY OF MCCOOK
Entity Type:Organization
Organization Name:CITY OF MCCOOK
Other - Org Name:MCCOOK CITY AND VOLUNTEER FIRE DEPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RESCUE CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-218-4392
Mailing Address - Street 1:10802 FARNAM DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-3237
Mailing Address - Country:US
Mailing Address - Phone:877-218-4392
Mailing Address - Fax:877-343-0131
Practice Address - Street 1:505 W. C ST
Practice Address - Street 2:
Practice Address - City:MCCOOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3672
Practice Address - Country:US
Practice Address - Phone:308-345-5710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-10
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE50333416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
590014589OtherRAILROAD MEDICARE
NE09486OtherBLUE CROSS NEBRASKA
NE=========00Medicaid
NE09486OtherBLUE CROSS NEBRASKA