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General NPI Number Information
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NPI Number | 1013165901
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Entity Type | Organization
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Legal Business Name | BIRCHWOOD FOUR CORNERS EMERGENCY SERVICES DISTRICT
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 101 N MAIN ST
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City | BIRCHWOOD
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State | WI
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Zip | 54817
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Country | US
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Telephone | 715-354-3003
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6253
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City | CAROL STREAM
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State | IL
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Zip | 60197-6253
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Country | US
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Telephone | 630-530-2988
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Fax | 630-832-9750
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Authorized Official
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Title or Position | AMBULANCE DIRECTOR
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Name | VINCE FAIRCHILD
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Credential |
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Telephone | 715-939-9174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 6000113
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License Number State | WI
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