Provider Demographics
NPI:1407583115
Name:CITY OF NEWMAN GROVE
Entity Type:Organization
Organization Name:CITY OF NEWMAN GROVE
Other - Org Name:NEWMAN GROVE FIRE AND RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMT / TRAINING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:POTMESIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-741-1820
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:531-895-5853
Mailing Address - Fax:
Practice Address - Street 1:200 S 8TH ST.
Practice Address - Street 2:
Practice Address - City:NEWMAN GROVE
Practice Address - State:NE
Practice Address - Zip Code:68758-5026
Practice Address - Country:US
Practice Address - Phone:402-741-1820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100274842-00Medicaid