Provider Demographics
NPI:1407845274
Name:DAKOTA CITY VOLUNTEER FIRE DEPARTMENT INC. OF DAKOTA CITY, NEBRASKA
Entity Type:Organization
Organization Name:DAKOTA CITY VOLUNTEER FIRE DEPARTMENT INC. OF DAKOTA CITY, NEBRASKA
Other - Org Name:DAKOTA CITY FIRE DEPARTMENT, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RESCUE CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:B
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-987-3409
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 1:1516 MYRTLE ST
Practice Address - Street 2:
Practice Address - City:DAKOTA CITY
Practice Address - State:NE
Practice Address - Zip Code:68731
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:2005-10-14
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09266OtherBLUE CROSS PROVIDER NO
NE590121425OtherRR MEDICARE
NE0586818OtherIOWA MEDICAID PROVIDER NO
NE4760427800Medicaid
NE590121425OtherRR MEDICARE