Provider Demographics
NPI:1689665143
Name:PLATTE COUNTY AMBULANCE COMPANY
Entity Type:Organization
Organization Name:PLATTE COUNTY AMBULANCE COMPANY
Other - Org Name:MIDWEST MEDICAL TRANSPORT CO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:H
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-910-1094
Mailing Address - Street 1:2155 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-3148
Mailing Address - Country:US
Mailing Address - Phone:402-563-3396
Mailing Address - Fax:402-563-0937
Practice Address - Street 1:2155 33RD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-3148
Practice Address - Country:US
Practice Address - Phone:402-563-3396
Practice Address - Fax:402-563-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE673416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========-00Medicaid