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General NPI Number Information
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NPI Number | 1871544171
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Entity Type | Organization
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Legal Business Name | SPARTA AREA AMBULANCE SERVICE LTD
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 618 STELTING ST
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City | SPARTA
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State | WI
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Zip | 54656-2325
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Country | US
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Telephone | 608-269-4949
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Fax | 608-269-8568
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Provider Business Mailing Address
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Address Line | 618 STELTING ST PO BOX 543
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City | SPARTA
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State | WI
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Zip | 54656-2325
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Country | US
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Telephone | 608-269-4949
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Fax | 608-269-8568
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT HESS
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Credential |
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Telephone | 608-269-4949
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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 | 6001011
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License Number State | WI
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