Provider Demographics
NPI:1609159961
Name:VILLAGE OF CLEARWATER
Entity Type:Organization
Organization Name:VILLAGE OF CLEARWATER
Other - Org Name:CLEARWATER VOL.FIRE AND RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:O
Authorized Official - Last Name:HANKLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-485-2582
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:402-991-0719
Practice Address - Street 1:628 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:NE
Practice Address - Zip Code:68726
Practice Address - Country:US
Practice Address - Phone:402-485-2451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10713416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport