MEDICARE: NEW GLARUS EMERGENCY MEDICAL SERVICE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	41342100	OTHER	WI	HIRSP
2	000088544	OTHER		ADVOCARE MCHMO
3	1012335	OTHER		PHYSICIAN'S PLUS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	WI0100	OTHER		JOHN DEERE

General Provider Information

NPI Number	:	1073567848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW GLARUS EMERGENCY MEDICAL SERVICE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 286
Second Line	:
City	:	NEW GLARUS
State	:	WI
Zip	:	53574-0286
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 3RD AVE
Second Line	:
City	:	NEW GLARUS
State	:	WI
Zip	:	53574-9772
Country	:	US
Telephone Number	:	608-527-5067
Fax Number	:

Authorized Official
Title or Position	:	CHIEF
Name	:	KRIS MUELLER
Credential	:
Telephone Number	:	608-527-5067

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	10/09/2012

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