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General NPI Number Information
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NPI Number | 1881701258
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Entity Type | Organization
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Legal Business Name | WAUNAKEE AREA EMERGENCY MEDICAL SERVICE
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 201 N KLEIN DR
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City | WAUNAKEE
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State | WI
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Zip | 53597-1145
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Country | US
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Telephone | 608-849-7522
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Fax | 608-849-7583
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Provider Business Mailing Address
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Address Line | PO BOX 33 201 N KLEIN DR
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City | WAUNAKEE
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State | WI
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Zip | 53597-0033
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Country | US
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Telephone | 608-849-7522
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Fax | 608-849-7583
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Authorized Official
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Title or Position | SERVICE ADMINISTRATOR
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Name | MR. JAY M GAWLIKOSKI
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Credential |
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Telephone | 608-849-7522
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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 | 6001221
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License Number State | WI
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