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General NPI Number Information
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NPI Number | 1407801905
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Entity Type | Organization
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Legal Business Name | CITY OF CUBA CITY
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 1013 SOUTH MAIN
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City | CUBA CITY
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State | WI
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Zip | 53807
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Country | US
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Telephone | 608-744-8753
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 S MAIN ST
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City | CUBA CITY
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State | WI
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Zip | 53807-1599
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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 | MARIE WIEDERHOLT
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Credential |
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Telephone | 608-744-8753
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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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