Healthcare Provider Details

I. General information

NPI: 1902851454
Provider Name (Legal Business Name): CAMBRIDGE AREA EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 10/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W MAIN
CAMBRIDGE WI
53523
US

IV. Provider business mailing address

PO BOX 272
CAMBRIDGE WI
53523-0272
US

V. Phone/Fax

Practice location:
  • Phone: 608-423-3511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: JIM BAULDAUF
Title or Position: DIRECTOR
Credential:
Phone: 608-423-3511