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General NPI Number Information
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NPI Number | 1801097902
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Entity Type | Organization
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Legal Business Name | AVOCA & RURAL FIRE & EMS DISTRICT
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 406 EAST MAIN STREET PO 178
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City | AVOCA
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State | WI
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Zip | 53506-0178
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Country | US
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Telephone | 608-532-6510
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 192
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City | AVOCA
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State | WI
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Zip | 53506-0192
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Country | US
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Telephone | 608-475-4039
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Fax |
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Authorized Official
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Title or Position | CHIEF/DIRCTOR OF SERVICES
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Name | JOSHUA ERIC KAMMERUDE
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Credential |
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Telephone | 608-475-4039
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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 | 60-01373
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License Number State | WI
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