Provider Demographics
NPI:1578736294
Name:SIOUX COUNTY RESCUE UNIT
Entity Type:Organization
Organization Name:SIOUX COUNTY RESCUE UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:
Authorized Official - First Name:ZANYA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FAINT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-572-4019
Mailing Address - Street 1:6907 N 102ND CIR
Mailing Address - Street 2:PO BOX 641880
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-3062
Mailing Address - Country:US
Mailing Address - Phone:402-572-4019
Mailing Address - Fax:
Practice Address - Street 1:479 MAIN STREET
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NE
Practice Address - Zip Code:69346
Practice Address - Country:US
Practice Address - Phone:402-572-4019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12683416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEPENDMedicaid
NEPENDMedicaid