Provider Demographics
NPI:1467158758
Name:MONDAMIN FIRE-RESCUE INC
Entity type:Organization
Organization Name:MONDAMIN FIRE-RESCUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LILJEDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:531-895-5853
Mailing Address - Street 1:10802 FARNAM DR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-3237
Mailing Address - Country:US
Mailing Address - Phone:531-895-5853
Mailing Address - Fax:877-343-0131
Practice Address - Street 1:602 MAPLE ST
Practice Address - Street 2:
Practice Address - City:MONDAMIN
Practice Address - State:IA
Practice Address - Zip Code:51557-2074
Practice Address - Country:US
Practice Address - Phone:712-646-2919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-07
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport