Coleridge Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

COLERIDGE AMBULANCE SERVICE

Practice address

217 East Broadway St.
Coleridge, NE 68727-0276

Phone

(402) 283-4464

Fax

(402) 283-4464

NPI assigned

Mar 27, 2007

Last updated

Aug 22, 2020By 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

George R Hefner

Title

Chairman of Village Board

Phone

(402) 283-4464

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619095569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276",
            "address_2": "217 EAST BROADWAY ST.",
            "city": "COLERIDGE",
            "state": "NE",
            "postal_code": "687270276",
            "telephone_number": "402-283-4464",
            "fax_number": "402-283-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 EAST BROADWAY ST.",
            "city": "COLERIDGE",
            "state": "NE",
            "postal_code": "687270276",
            "telephone_number": "402-283-4464",
            "fax_number": "402-283-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLERIDGE AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEFNER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHAIRMAN OF VILLAGE BOARD",
        "authorized_official_telephone_number": "402-283-4464"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100250807-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.