Provider Demographics
NPI:1225212053
Name:FRONTIER COUNTY AMBULANCE SERVICE
Entity Type:Organization
Organization Name:FRONTIER COUNTY AMBULANCE SERVICE
Other - Org Name:FRONTIER CO AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:308-737-7100
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 1:106 CUSTER AVE
Practice Address - Street 2:
Practice Address - City:CURTIS
Practice Address - State:NE
Practice Address - Zip Code:69025-2835
Practice Address - Country:US
Practice Address - Phone:308-737-7100
Practice Address - Fax:877-343-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11243416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025588300Medicaid
NE09288OtherBLUE CROSS PROVIDER NO
091745Medicare PIN