Provider Demographics
NPI:1811182439
Name:WALTHILL RURAL FIRE PROTECTION DISTRICT INC.
Entity type:Organization
Organization Name:WALTHILL RURAL FIRE PROTECTION DISTRICT INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RESCUE CAPTAIN
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-846-5921
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:224 MAIN STREET
Mailing Address - City:WALTHILL
Mailing Address - State:NE
Mailing Address - Zip Code:68067
Mailing Address - Country:US
Mailing Address - Phone:402-846-5921
Mailing Address - Fax:402-846-5114
Practice Address - Street 1:323 NORTH BROUGHTON
Practice Address - Street 2:
Practice Address - City:WALTHILL
Practice Address - State:NE
Practice Address - Zip Code:68067
Practice Address - Country:US
Practice Address - Phone:402-846-5921
Practice Address - Fax:402-846-5114
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WALTHILL RESCUE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-06
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1315146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE091815Medicare PIN