Provider Demographics
NPI:1316505324
Name:GARDEN COUNTY TRANSPORTATION
Entity type:Organization
Organization Name:GARDEN COUNTY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-778-7057
Mailing Address - Street 1:PO BOX 350
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:NE
Mailing Address - Zip Code:69154-0350
Mailing Address - Country:US
Mailing Address - Phone:308-778-7057
Mailing Address - Fax:308-772-3296
Practice Address - Street 1:619 MAIN ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:NE
Practice Address - Zip Code:69154-5034
Practice Address - Country:US
Practice Address - Phone:308-778-7057
Practice Address - Fax:308-772-3296
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARDEN COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEN181977Medicaid