Provider Demographics
NPI:1093892879
Name:BANCROFT RURAL FIRE DISTRICT
Entity Type:Organization
Organization Name:BANCROFT RURAL FIRE DISTRICT
Other - Org Name:BANCROFT RURAL VOL. FIRE AND RESUCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RESCUE CAPT.
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-572-4019
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 1:401 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BANCROFT
Practice Address - State:NE
Practice Address - Zip Code:68004
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:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10203416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09464OtherBLUE CROSS PROVIDER NO
NE10025024700Medicaid
NE09464OtherBLUE CROSS PROVIDER NO
NE091867Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO