Provider Demographics
NPI:1962463117
Name:BRAINARD FIRE DEPARTMENT
Entity Type:Organization
Organization Name:BRAINARD FIRE DEPARTMENT
Other - Org Name:BRAINARD VOL FIRE & RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:MR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:JELINEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-572-4019
Mailing Address - Street 1:116 E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BRAINARD
Mailing Address - State:NE
Mailing Address - Zip Code:68626-3524
Mailing Address - Country:US
Mailing Address - Phone:402-572-4019
Mailing Address - Fax:402-965-8594
Practice Address - Street 1:116 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRAINARD
Practice Address - State:NE
Practice Address - Zip Code:68626-3524
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:2006-03-29
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE09297OtherBLUE CROSS PROVIDER NUMBE
NE590014254OtherRR MEDICARE PROVIDER NO
NE09297OtherBLUE CROSS PROVIDER NUMBE
NE590014254OtherRR MEDICARE PROVIDER NO