Provider Demographics
NPI:1982664215
Name:CITY OF PLATTSMOUTH
Entity Type:Organization
Organization Name:CITY OF PLATTSMOUTH
Other - Org Name:PLATTSMOUTH VOLUNTEER RESCUE SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF EMS
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT-P
Authorized Official - Phone:402-296-6041
Mailing Address - Street 1:136 NORTH 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048
Mailing Address - Country:US
Mailing Address - Phone:402-296-6041
Mailing Address - Fax:402-296-2391
Practice Address - Street 1:127 NORTH 5TH ST
Practice Address - Street 2:
Practice Address - City:PLATTSMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68048
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:2006-03-23
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE51153416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
590121138OtherRAILROAD MEDICARE NO
NE09453OtherBLUE CROSS PROVIDER NO
NE09453OtherBLUE CROSS PROVIDER NO
NE09453OtherBLUE CROSS PROVIDER NO