Provider Demographics
NPI:1629029608
Name:SIDNEY VOLUNTEER FIRE & RESCUE
Entity Type:Organization
Organization Name:SIDNEY VOLUNTEER FIRE & RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SHIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-374-2204
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 1:903 INDIANA ST
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:IA
Practice Address - Zip Code:51652-8034
Practice Address - Country:US
Practice Address - Phone:712-374-2204
Practice Address - Fax:402-572-4019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23603003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0100987Medicaid
610713100OtherUS DEPT OF LABOR
8181742OtherUNITED HEALTHCARE
IA0186213Medicaid
IA590009309OtherRAILROAD MEDICARE
IA18621OtherBLUE CROSS BLUE SHIELD
590009309OtherRAILROAD MEDICARE
IAI8621Medicare PIN