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General NPI Number Information
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NPI Number | 1942285911
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Entity Type | Organization
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Legal Business Name | NIAGARA AREA EMERGENCY UNIT, INC
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1241 JACKSON ST
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City | NIAGARA
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State | WI
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Zip | 54151-1233
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Country | US
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Telephone | 715-251-3136
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Fax | 715-251-3136
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Provider Business Mailing Address
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Address Line | PO BOX 66
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City | NIAGARA
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State | WI
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Zip | 54151-0066
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Country | US
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Telephone | 715-251-3136
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Fax | 715-251-3136
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Authorized Official
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Title or Position | BILLER
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Name | MR. ANDREW CLETUS RABIDEAU
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Credential | EMT-B
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Telephone | 715-251-3136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 6001089
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License Number State | WI
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