Provider Demographics
NPI:1356457212
Name:CITY OF SAINT PAUL
Entity Type:Organization
Organization Name:CITY OF SAINT PAUL
Other - Org Name:ST PAUL RESCUE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RESCUE CLERK
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYBERRY
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 1:704 6TH ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:NE
Practice Address - Zip Code:68873-2015
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:2006-08-22
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1278341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09431OtherBLUE CROSS PROVIDER NO
NEP00101979OtherRAILROAD MEDICARE PROVIDE
NEP00101979OtherRAILROAD MEDICARE PROVIDE
091848Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO