Provider Demographics
NPI:1962464990
Name:VILLAGE OF CLATONIA
Entity type:Organization
Organization Name:VILLAGE OF CLATONIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:DENAE
Authorized Official - Last Name:UHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-223-9644
Mailing Address - Street 1:PO BOX 745
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:NE
Mailing Address - Zip Code:68450-0745
Mailing Address - Country:US
Mailing Address - Phone:402-335-7792
Mailing Address - Fax:
Practice Address - Street 1:255 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CLATONIA
Practice Address - State:NE
Practice Address - Zip Code:68328-5018
Practice Address - Country:US
Practice Address - Phone:402-223-9644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10693416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE590010033OtherRR MEDICARE PROVIDER NO
NE09446OtherBCBS PROVIDER NUMBER
NE590010033OtherRR MEDICARE PROVIDER NO
NE091890Medicare ID - Type UnspecifiedPROVIDER NUMBER