Provider Demographics
NPI:1871657791
Name:BENNINGTON VOLUNTEER FIRE
Entity Type:Organization
Organization Name:BENNINGTON VOLUNTEER FIRE
Other - Org Name:BENNINGTON VOL FIRE & RESCUE DEPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS ACCT CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:ARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-572-4019
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:402-571-4019
Mailing Address - Fax:402-965-8594
Practice Address - Street 1:15509 WAREHOUSE STREET
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:NE
Practice Address - Zip Code:68007
Practice Address - Country:US
Practice Address - Phone:402-572-4019
Practice Address - Fax:402-965-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE51003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09264OtherBC NE PROVIDER NUMBER
NE590011316OtherRR MEDICARE PROVIDER NUMB
NE09264OtherBC NE PROVIDER NUMBER
NE09264OtherBC NE PROVIDER NUMBER