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General NPI Number Information
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NPI Number | 1326025065
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Entity Type | Organization
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Legal Business Name | MEDA-CARE AMBULANCE CORP
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Dates
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Enumeration Date | 12/23/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2515 W VLIET ST
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City | MILWAUKEE
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State | WI
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Zip | 53205-1835
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Country | US
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Telephone | 414-342-1148
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Fax | 414-342-0888
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Provider Business Mailing Address
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Address Line | 4935 W FOREST HOME AVE
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City | MILWAUKEE
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State | WI
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Zip | 53219-4722
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Country | US
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Telephone | 414-327-2880
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Fax | 414-327-1049
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | YVONNE S LARSEN
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Credential |
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Telephone | 414-327-2880
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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 | 6000115
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License Number State | WI
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