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General NPI Number Information
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NPI Number | 1164657714
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Entity Type | Organization
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Legal Business Name | EDGERTON FIRE PROTECTION DISTRICT
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Dates
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Enumeration Date | 05/27/2009
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Last Update Date | 05/27/2009
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Provider Practice Location Address
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Address Line | 621 N MAIN ST
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City | EDGERTON
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State | WI
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Zip | 53534-1562
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Country | US
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Telephone | 608-884-3327
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Fax |
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Provider Business Mailing Address
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Address Line | 621 N MAIN ST
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City | EDGERTON
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State | WI
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Zip | 53534-1562
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Country | US
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Telephone | 608-884-3327
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Fax |
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Authorized Official
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Title or Position | CHIEF
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Name | BRIAN DEMROW
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Credential |
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Telephone | 608-884-3327
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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 | WI
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