Provider Demographics
NPI:1407823396
Name:CITY OF HARTINGTON
Entity Type:Organization
Organization Name:CITY OF HARTINGTON
Other - Org Name:HARTINGTON AMBULANCE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:CITY CLERK TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LENZEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-254-6353
Mailing Address - Street 1:107 W STATE ST
Mailing Address - Street 2:PO BOX 427
Mailing Address - City:HARTINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68739
Mailing Address - Country:US
Mailing Address - Phone:402-254-6353
Mailing Address - Fax:402-254-6391
Practice Address - Street 1:107 W STATE ST
Practice Address - Street 2:
Practice Address - City:HARTINGTON
Practice Address - State:NE
Practice Address - Zip Code:68739
Practice Address - Country:US
Practice Address - Phone:402-254-6353
Practice Address - Fax:402-254-6391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0005939OtherTRADING PARTNER NUMBER
NE091719Medicaid
NE0005939OtherTRADING PARTNER NUMBER