Healthcare Provider Details

I. General information

NPI: 1659560449
Provider Name (Legal Business Name): CORNELL AREA AMBULANCE SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 S 3RD ST
CORNELL WI
54732-8303
US

IV. Provider business mailing address

PO BOX 3
CORNELL WI
54732-0003
US

V. Phone/Fax

Practice location:
  • Phone: 715-239-3346
  • Fax:
Mailing address:
  • Phone: 715-239-3346
  • 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: AMY J. CLARK
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 715-828-1258