Healthcare Provider Details

I. General information

NPI: 1396955860
Provider Name (Legal Business Name): CHETEK AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1224 RAILROAD AVE
CHETEK WI
54728-0047
US

IV. Provider business mailing address

PO BOX 47
CHETEK WI
54728-0047
US

V. Phone/Fax

Practice location:
  • Phone: 715-924-4211
  • Fax: 715-924-4695
Mailing address:
  • Phone: 715-924-4211
  • Fax: 715-924-4695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number6000571
License Number StateWI

VIII. Authorized Official

Name: RYAN OLSON
Title or Position: DIRECTOR
Credential: AO
Phone: 715-924-4211