Provider Demographics
NPI:1285899609
Name:CITY OF SUTTON
Entity type:Organization
Organization Name:CITY OF SUTTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UBCLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:LANA
Authorized Official - Middle Name:K
Authorized Official - Last Name:EBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-773-5607
Mailing Address - Street 1:107 W GROVE ST
Mailing Address - Street 2:PO BOX 430
Mailing Address - City:SUTTON
Mailing Address - State:NE
Mailing Address - Zip Code:68979-0430
Mailing Address - Country:US
Mailing Address - Phone:402-773-5607
Mailing Address - Fax:402-773-5501
Practice Address - Street 1:107 W GROVE ST
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:NE
Practice Address - Zip Code:68979-0430
Practice Address - Country:US
Practice Address - Phone:402-773-5607
Practice Address - Fax:402-773-5501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE091785341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE091785Medicare PIN