Provider Demographics
NPI:1154870830
Name:TOWN OF BURNS
Entity type:Organization
Organization Name:TOWN OF BURNS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:EVELETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-701-6598
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:402-991-7866
Mailing Address - Fax:
Practice Address - Street 1:346 SO PRAIRIE
Practice Address - Street 2:
Practice Address - City:BURNS
Practice Address - State:WY
Practice Address - Zip Code:82053-9998
Practice Address - Country:US
Practice Address - Phone:307-707-6598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY0113416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport