Healthcare Provider Details

I. General information

NPI: 1164601522
Provider Name (Legal Business Name): VILLAGE OF PLUM CITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 MAPLE AVE W
PLUM CITY WI
54761-9015
US

IV. Provider business mailing address

223 1ST ST
PLUM CITY WI
54761-9002
US

V. Phone/Fax

Practice location:
  • Phone: 715-647-2141
  • Fax:
Mailing address:
  • Phone: 715-647-2141
  • Fax: 336-510-5894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number6001242
License Number StateWI

VIII. Authorized Official

Name: JOANNE KAREN HOVEY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 715-495-6963