Healthcare Provider Details

I. General information

NPI: 1316994569
Provider Name (Legal Business Name): LANCASTER EMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 NORTH WASHINGTON STREET
LANCASTER WI
58813-0293
US

IV. Provider business mailing address

2715 WEST FRANK STREET
EAU CLAIRE WI
54703
US

V. Phone/Fax

Practice location:
  • Phone: 608-723-6331
  • Fax: 608-723-7560
Mailing address:
  • Phone:
  • Fax: 715-834-5870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number6000396
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number10000396
License Number StateWI

VIII. Authorized Official

Name: MR. BRIAN M ALLEN
Title or Position: CHIEF
Credential: EMT INTERMEDIATE TEC
Phone: 608-723-6331