Provider Demographics
NPI:1417909607
Name:HUMPHREY VOLUNTEER FIRE DEPARTMENT
Entity Type:Organization
Organization Name:HUMPHREY VOLUNTEER FIRE DEPARTMENT
Other - Org Name:HUMPHREY VOL. FIRE AND RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RESCUE CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:WIEHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-923-0905
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:877-218-4392
Mailing Address - Fax:877-343-0131
Practice Address - Street 1:305 N 3RD ST
Practice Address - Street 2:
Practice Address - City:HUMPHREY
Practice Address - State:NE
Practice Address - Zip Code:68642-3135
Practice Address - Country:US
Practice Address - Phone:402-923-0905
Practice Address - Fax:402-923-9023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11583416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09265OtherBC BS OF NEBRASKA
F246867OtherMIDLANDS CHOICE
NE10025233200Medicaid
NE10025233200Medicaid