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General NPI Number Information
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NPI Number | 1154326692
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Entity Type | Organization
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Legal Business Name | BARABOO DISTRICT AMBULANCE SERVICE
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 135 4TH ST
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City | BARABOO
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State | WI
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Zip | 53913-2184
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Country | US
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Telephone | 608-356-3455
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Fax | 608-448-4703
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Provider Business Mailing Address
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Address Line | 135 4TH ST
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City | BARABOO
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State | WI
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Zip | 53913-2184
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Country | US
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Telephone | 608-356-3455
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Fax | 608-448-4703
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Authorized Official
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Title or Position | CHIEF / EMS DIRECTOR
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Name | CALEB C JOHNSON
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Credential |
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Telephone | 608-393-1977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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