Provider Demographics
NPI:1295863900
Name:LITCHFIELD RFD AMBULANCE
Entity Type:Organization
Organization Name:LITCHFIELD RFD AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:D
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-446-2302
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:NE
Mailing Address - Zip Code:68852-0003
Mailing Address - Country:US
Mailing Address - Phone:308-446-2302
Mailing Address - Fax:
Practice Address - Street 1:221 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:NE
Practice Address - Zip Code:68852-0003
Practice Address - Country:US
Practice Address - Phone:308-446-2302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11743416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025339900Medicaid
NE10025339900Medicaid