Provider Demographics
NPI:1467579185
Name:SILVER CREEK AMBULANCE SERVICE
Entity Type:Organization
Organization Name:SILVER CREEK AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:THAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:EUSE
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:308-773-2117
Mailing Address - Street 1:506 HIGHWAY 30
Mailing Address - Street 2:P.O. BOX 27
Mailing Address - City:SILVER CREEK
Mailing Address - State:NE
Mailing Address - Zip Code:68663-0027
Mailing Address - Country:US
Mailing Address - Phone:308-773-2117
Mailing Address - Fax:
Practice Address - Street 1:506 HIGHWAY 30
Practice Address - Street 2:BOX 27
Practice Address - City:SILVER CREEK
Practice Address - State:NE
Practice Address - Zip Code:68663-0027
Practice Address - Country:US
Practice Address - Phone:308-773-2117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE36769341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance