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General NPI Number Information
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NPI Number | 1619003662
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Entity Type | Organization
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Legal Business Name | EDGAR VOLUNTEER FIRE DEPT
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 108 BEECH ST BOX 123
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City | EDGAR
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State | WI
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Zip | 54426-0123
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Country | US
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Telephone | 715-352-2892
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Fax | 715-352-2892
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Provider Business Mailing Address
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Address Line | 10802 FARNAM DR
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City | OMAHA
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State | NE
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Zip | 68154-3237
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Country | US
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Telephone | 531-895-5853
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Fax | 877-343-0131
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Authorized Official
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Title or Position | EMS BILLING SECRETARY
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Name | CONNIE HALVORSEN
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Credential |
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Telephone | 531-895-5853
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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 | 6000119
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License Number State | WI
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