Healthcare Provider Details

I. General information

NPI: 1437343167
Provider Name (Legal Business Name): SPRING GREEN FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 W MADISON ST
SPRING GREEN WI
53588-9208
US

IV. Provider business mailing address

495 W MADISON ST
SPRING GREEN WI
53588-9208
US

V. Phone/Fax

Practice location:
  • Phone: 608-588-4259
  • Fax: 608-588-3516
Mailing address:
  • Phone: 608-588-4259
  • Fax: 608-588-3516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JANEEN LEA ANDERSON
Title or Position: SECRETARY/TREASURER
Credential:
Phone: 608-588-4259