Provider Demographics
NPI:1326148628
Name:CITY OF OSCEOLA
Entity Type:Organization
Organization Name:CITY OF OSCEOLA
Other - Org Name:OSCEOLA AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY CLERK TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOHANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-747-3411
Mailing Address - Street 1:PO BOX 701
Mailing Address - Street 2:350 N. STATE ST.
Mailing Address - City:OSCEOLA
Mailing Address - State:NE
Mailing Address - Zip Code:68651-0701
Mailing Address - Country:US
Mailing Address - Phone:402-747-3411
Mailing Address - Fax:402-747-8191
Practice Address - Street 1:331 N. NANCE ST.
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:NE
Practice Address - Zip Code:68651
Practice Address - Country:US
Practice Address - Phone:402-747-3411
Practice Address - Fax:402-747-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12193416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========00Medicaid
NE=========00Medicaid