Provider Demographics
NPI:1275936403
Name:VILLAGE OF REPUBLICAN CITY
Entity Type:Organization
Organization Name:VILLAGE OF REPUBLICAN CITY
Other - Org Name:REPUBLICAN CITY VOL RESCUE SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLERK/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MISSY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-799-4075
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:402-991-0719
Practice Address - Street 1:102 TRUMAN AVE
Practice Address - Street 2:
Practice Address - City:REPUBLICAN CITY
Practice Address - State:NE
Practice Address - Zip Code:68971
Practice Address - Country:US
Practice Address - Phone:308-779-4075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12503416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport