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General NPI Number Information
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NPI Number | 1346578135
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Entity Type | Organization
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Legal Business Name | UNITED EMERGENCY MEDICAL RESPONSE, LLC
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 3530 BOHN DRIVE
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-6971
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Country | US
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Telephone | 715-459-3532
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Fax | 715-424-6989
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Provider Business Mailing Address
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Address Line | 3530 BOHN DRIVE
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-6971
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Country | US
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Telephone | 715-459-3532
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Fax | 715-424-6989
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Authorized Official
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Title or Position | DIRECTOR OF AMBULANCE OPERATIONS
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Name | MR. GARY JOHNSON
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Credential | PARAMEDIC
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Telephone | 715-459-3532
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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 | 6604885
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License Number State | WI
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