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General NPI Number Information
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NPI Number | 1609827997
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Entity Type | Organization
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Legal Business Name | ELLSWORTH AREA AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 151 S PLUM ST
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City | ELLSWORTH
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State | WI
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Zip | 54011-4137
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Country | US
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Telephone | 715-273-4879
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 718
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City | ELLSWORTH
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State | WI
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Zip | 54011-0718
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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 | DIRECTOR
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Name | DAN MORTH
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Credential |
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Telephone | 715-273-4879
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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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