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General NPI Number Information
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NPI Number | 1659560449
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Entity Type | Organization
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Legal Business Name | CORNELL AREA AMBULANCE SERVICE
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 412 S 3RD ST
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City | CORNELL
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State | WI
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Zip | 54732-8303
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Country | US
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Telephone | 715-239-3346
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3
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City | CORNELL
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State | WI
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Zip | 54732-0003
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Country | US
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Telephone | 715-239-3346
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | AMY J. CLARK
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Credential |
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Telephone | 715-828-1258
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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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