Healthcare Provider Details

I. General information

NPI: 1205821584
Provider Name (Legal Business Name): HATLEY AREA FIRE & AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 CLARK ST
HATLEY WI
54440-8704
US

IV. Provider business mailing address

303 E MAIN ST
BOWLER WI
54416-9704
US

V. Phone/Fax

Practice location:
  • Phone: 715-446-2650
  • Fax: 715-446-2241
Mailing address:
  • Phone: 715-793-3333
  • Fax: 715-793-1313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number60-01379
License Number StateWI

VIII. Authorized Official

Name: MRS. KATHY MAVES
Title or Position: OFFICE MANAGER
Credential:
Phone: 715-793-3333