Provider Demographics
NPI:1386729986
Name:CITY OF EDGAR
Entity type:Organization
Organization Name:CITY OF EDGAR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRABHORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-224-5145
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:105 5TH STREET
Mailing Address - City:EDGAR
Mailing Address - State:NE
Mailing Address - Zip Code:68935-0485
Mailing Address - Country:US
Mailing Address - Phone:402-224-5145
Mailing Address - Fax:402-224-3055
Practice Address - Street 1:105 5TH STREET
Practice Address - Street 2:
Practice Address - City:EDGAR
Practice Address - State:NE
Practice Address - Zip Code:68935
Practice Address - Country:US
Practice Address - Phone:402-224-3005
Practice Address - Fax:402-408-2888
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF EDGAR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-25
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11033416L0300X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099728Medicare PIN
NE099729Medicare PIN