Healthcare Provider Details

I. General information

NPI: 1619003662
Provider Name (Legal Business Name): EDGAR VOLUNTEER FIRE DEPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 BEECH ST BOX 123
EDGAR WI
54426-0123
US

IV. Provider business mailing address

10802 FARNAM DR
OMAHA NE
68154-3237
US

V. Phone/Fax

Practice location:
  • Phone: 715-352-2892
  • Fax: 715-352-2892
Mailing address:
  • Phone: 531-895-5853
  • Fax: 877-343-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number6000119
License Number StateWI

VIII. Authorized Official

Name: CONNIE HALVORSEN
Title or Position: EMS BILLING SECRETARY
Credential:
Phone: 531-895-5853