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General NPI Number Information
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NPI Number | 1215980453
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Entity Type | Organization
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Legal Business Name | SAUK PRAIRIE AMBULANCE ASSOCIATION
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 80 1ST ST
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City | PRAIRIE DU SAC
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State | WI
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Zip | 53578-1550
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Country | US
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Telephone | 608-643-4183
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Fax |
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Provider Business Mailing Address
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Address Line | 110 WASHINGTON ST
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City | SAUK CITY
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State | WI
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Zip | 53583-1131
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MIKE CODY
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Credential |
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Telephone | 608-643-4183
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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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