=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003938960
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NIAGARA AREA EMERGENCY UNIT, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2007
-----------------------------------------------------
Last Update Date | 02/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1241 JACKSON ST
-----------------------------------------------------
City | NIAGARA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54151
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-251-3136
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 66
-----------------------------------------------------
City | NIAGARA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54151-0066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 715-251-3136
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY
-----------------------------------------------------
Name | TRACY DAUN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 715-251-3136
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------