Healthcare Provider Details

I. General information

NPI: 1710725593
Provider Name (Legal Business Name): BADGERLAND EMERGENCY MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10378 STATE HIGHWAY 71 UNIT A1
SPARTA WI
54656-5433
US

IV. Provider business mailing address

1501 W WISCONSIN ST
SPARTA WI
54656-2241
US

V. Phone/Fax

Practice location:
  • Phone: 608-487-5710
  • Fax:
Mailing address:
  • Phone: 608-399-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. MICHAEL HUBER
Title or Position: DIRECTOR
Credential:
Phone: 608-399-8700