Provider Demographics
NPI:1629257100
Name:ROSALIE RURAL FIRE DISTRICT
Entity Type:Organization
Organization Name:ROSALIE RURAL FIRE DISTRICT
Other - Org Name:ROSALIE FIRE & RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MARLON
Authorized Official - Middle Name:
Authorized Official - Last Name:HENNIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-863-2325
Mailing Address - Street 1:210 S FARLEY ST
Mailing Address - Street 2:
Mailing Address - City:ROSALIE
Mailing Address - State:NE
Mailing Address - Zip Code:68055-0225
Mailing Address - Country:US
Mailing Address - Phone:402-863-2272
Mailing Address - Fax:
Practice Address - Street 1:212 S FARLEY
Practice Address - Street 2:
Practice Address - City:ROSALIE
Practice Address - State:NE
Practice Address - Zip Code:68055-0155
Practice Address - Country:US
Practice Address - Phone:402-863-2325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025164800Medicaid
NE099244Medicare Oscar/Certification