Healthcare Provider Details

I. General information

NPI: 1609290873
Provider Name (Legal Business Name): BADGER EMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2014
Last Update Date: 02/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N873 CLUB CIRCLE DR
PRAIRIE DU SAC WI
53578-9560
US

IV. Provider business mailing address

N873 CLUB CIRCLE DR
PRAIRIE DU SAC WI
53578-9560
US

V. Phone/Fax

Practice location:
  • Phone: 608-393-8848
  • Fax: 608-370-6480
Mailing address:
  • Phone: 608-393-8848
  • Fax: 608-370-6480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: PAMELA HALVERSON
Title or Position: SECRETARY-TREASURER
Credential:
Phone: 608-393-8848