Healthcare Provider Details

I. General information

NPI: 1902851108
Provider Name (Legal Business Name): THORP AREA AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S WILSON
THORP WI
54771
US

IV. Provider business mailing address

PO BOX 558
THORP WI
54771-0558
US

V. Phone/Fax

Practice location:
  • Phone: 715-669-5292
  • 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: ROBERT EBBEN
Title or Position: DIRECTOR
Credential:
Phone: 715-669-5292