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General NPI Number Information
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NPI Number | 1700833167
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Entity Type | Organization
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Legal Business Name | CITY OF DODGEVILLE
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 01/03/2013
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Provider Practice Location Address
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Address Line | 100 E FOUNTAIN ST
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City | DODGEVILLE
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State | WI
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Zip | 53533-1750
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Country | US
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Telephone | 608-935-5111
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Fax | 608-935-9477
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Provider Business Mailing Address
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Address Line | 2715 W FRANK ST
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City | EAU CLAIRE
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State | WI
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Zip | 54703-2593
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Country | US
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Telephone |
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Fax | 715-834-5870
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Authorized Official
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Title or Position | CHIEF
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Name | BRIAN CUSHMAN
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Credential | EMT I
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Telephone | 608-935-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 60 01312
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 146M00000X
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Taxonomy Name | Intermediate Emergency Medical Technician
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License Number | 60 01312
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License Number State | WI
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