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General NPI Number Information
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NPI Number | 1710932108
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Entity Type | Organization
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Legal Business Name | CITY OF TOMAH
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 400 N GLENDALE AVENUE
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City | TOMAH
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State | WI
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Zip | 54660
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Country | US
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Telephone | 608-374-7460
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Fax | 608-374-7461
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Provider Business Mailing Address
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Address Line | 400 N GLENDALE AVENUE
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City | TOMAH
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State | WI
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Zip | 54660
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Country | US
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Telephone | 608-374-7460
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Fax | 608-374-7461
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Authorized Official
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Title or Position | DEPUTY EMS CHIEF
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Name | ADAM LEE ROBARGE
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Credential |
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Telephone | 608-374-7460
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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 | 6000339
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License Number State | WI
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