Provider Demographics
NPI:1174530281
Name:COUNTY OF KIMBALL
Entity type:Organization
Organization Name:COUNTY OF KIMBALL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TRANSIT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-235-0244
Mailing Address - Street 1:114 E 3RD ST STE 8
Mailing Address - Street 2:
Mailing Address - City:KIMBALL
Mailing Address - State:NE
Mailing Address - Zip Code:69145-1456
Mailing Address - Country:US
Mailing Address - Phone:308-235-0262
Mailing Address - Fax:
Practice Address - Street 1:114 E 3RD ST STE 8
Practice Address - Street 2:
Practice Address - City:KIMBALL
Practice Address - State:NE
Practice Address - Zip Code:69145-1456
Practice Address - Country:US
Practice Address - Phone:308-235-0262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026003101Medicaid
NE28729080OtherNEBRASKA DHHS