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General NPI Number Information
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NPI Number | 1568517688
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Entity Type | Organization
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Legal Business Name | COUNTY OF WAUSHARA
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 401 RUTHS WAY
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City | WAUTOMA
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State | WI
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Zip | 54982-5111
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Country | US
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Telephone | 920-787-6601
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Fax | 920-787-0423
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Provider Business Mailing Address
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Address Line | 401 RUTHS WAY
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City | WAUTOMA
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State | WI
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Zip | 54982-5111
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Country | US
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Telephone | 920-787-6601
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Fax | 920-787-0423
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Authorized Official
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Title or Position | DEPUTY EMS CHIEF
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Name | STEVEN R WOODSTOCK
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Credential | PARAMEDIC
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Telephone | 920-787-6601
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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 | 6001117
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License Number State | WI
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