Healthcare Provider Details

I. General information

NPI: 1619159365
Provider Name (Legal Business Name): ARCADIA AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2007
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464 S SAINT JOSEPH AVE
ARCADIA WI
54612-1401
US

IV. Provider business mailing address

464 S SAINT JOSEPH AVE
ARCADIA WI
54612-1401
US

V. Phone/Fax

Practice location:
  • Phone: 608-323-4359
  • Fax:
Mailing address:
  • Phone: 608-323-4359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number6000941
License Number StateWI

VIII. Authorized Official

Name: TRISHA PEHLER
Title or Position: AMBULANCE COORDINATOR/EMT
Credential:
Phone: 608-323-4359