Healthcare Provider Details

I. General information

NPI: 1659366979
Provider Name (Legal Business Name): TIGERTON AREA AMBULANCE SERVICE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TIGERTON AREA AMBULANCE SERVICE 780 N. BEECH ST
TIGERTON WI
54486-0008
US

IV. Provider business mailing address

TIGERTON AREA AMBULANCE SERVICE 780 N. BEECH ST, P.O BOX 8
TIGERTON WI
54486-0008
US

V. Phone/Fax

Practice location:
  • Phone: 715-535-2222
  • Fax:
Mailing address:
  • Phone: 715-535-2222
  • 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: CHRISTINE D RICHTER
Title or Position: DIRECTOR
Credential:
Phone: 715-535-2222