Healthcare Provider Details

I. General information

NPI: 1801097902
Provider Name (Legal Business Name): AVOCA & RURAL FIRE & EMS DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 EAST MAIN STREET PO 178
AVOCA WI
53506-0178
US

IV. Provider business mailing address

PO BOX 192
AVOCA WI
53506-0192
US

V. Phone/Fax

Practice location:
  • Phone: 608-532-6510
  • Fax:
Mailing address:
  • Phone: 608-475-4039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number60-01373
License Number StateWI

VIII. Authorized Official

Name: JOSHUA ERIC KAMMERUDE
Title or Position: CHIEF/DIRCTOR OF SERVICES
Credential:
Phone: 608-475-4039