Healthcare Provider Details

I. General information

NPI: 1417074840
Provider Name (Legal Business Name): LOYAL UNIFIED FIRE & AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 03/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W4325 STATE HIGHWAY 98
LOYAL WI
54446-8534
US

IV. Provider business mailing address

PO BOX 175
LOYAL WI
54446-0175
US

V. Phone/Fax

Practice location:
  • Phone: 715-255-8721
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number6000482
License Number StateWI

VIII. Authorized Official

Name: MARGIE SZYMANSKI
Title or Position: TREASURER
Credential:
Phone: 715-255-8721