City of Friend

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1122 Issued in NE

Legal business name

CITY OF FRIEND

Doing business as

Friend Ambulance Service

Practice address

300 Spring St
Friend, NE 68359-1424

Phone

(877) 218-4392

Fax

(877) 343-0131

NPI assigned

Sep 14, 2006

Reactivated

Dec 19, 2008

Last updated

Feb 21, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kelly Paulsen

Title

Rescue Captain

Phone

(402) 416-1097

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Friend Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1437254349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 FARNAM DR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681543237",
            "telephone_number": "877-218-4392",
            "fax_number": "877-343-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SPRING ST",
            "city": "FRIEND",
            "state": "NE",
            "postal_code": "683591424",
            "telephone_number": "877-218-4392",
            "fax_number": "877-343-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF FRIEND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "deactivation_date": "2008-09-23",
        "reactivation_date": "2008-12-19",
        "status": "A",
        "authorized_official_last_name": "PAULSEN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "RESCUE CAPTAIN",
        "authorized_official_telephone_number": "402-416-1097",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NE",
            "license": "1122",
            "primary": true
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NE",
            "license": "1122",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09392",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025676100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friend Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Friend Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Korin Dawn Arp, LPN
• Cortney Marie Boeck, PA-C
• Claire Brejcha
• Thais Ravelle Brejcha
• Jennifer Buol, LPN
• Chantel Collier, NP
• Complete Rural Medicine
• County of Saline 68 School District (Friend Public School)
• Crete Area Medical Center (Friend Medical Clinic)
• Eric Daniel Daharsh, D.O.

• Land Ambulance in Friend, NE
• Providers in Friend, NE by specialty
• Land Ambulance in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.