Healthcare Provider Details

I. General information

NPI: 1740233477
Provider Name (Legal Business Name): NECEDAH FIRE DEPT AMBULANCE SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CENTER ST
NECEDAH WI
54646
US

IV. Provider business mailing address

PO BOX 249
NECEDAH WI
54646-0249
US

V. Phone/Fax

Practice location:
  • Phone: 608-565-2412
  • Fax:
Mailing address:
  • Phone:
  • 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: BILLY MURPHY
Title or Position: DIRECTOR
Credential:
Phone: 608-565-2412