Provider Demographics
NPI:1700928884
Name:VILLAGE OF TRENTON
Entity Type:Organization
Organization Name:VILLAGE OF TRENTON
Other - Org Name:TRENTON RESCUE SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
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:402-572-4019
Mailing Address - Fax:402-965-8594
Practice Address - Street 1:333 MAIN ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NE
Practice Address - Zip Code:69044-1701
Practice Address - Country:US
Practice Address - Phone:308-340-5250
Practice Address - Fax:402-965-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
590006109OtherRR MEDICARE PROVIDER NO
NE09386OtherBLUE CROSS PROVIDER
NE09386OtherBLUE CROSS PROVIDER
091876Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO