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General NPI Number Information
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NPI Number | 1992008775
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Entity Type | Organization
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Legal Business Name | DALLAS AREA AMBULANCE SERVICE
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Dates
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Enumeration Date | 12/16/2010
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 115 E BREWSTER ST
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City | PRAIRIE FARM
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State | WI
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Zip | 54762-0122
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Country | US
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Telephone | 715-455-2222
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Fax | 715-455-2223
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Provider Business Mailing Address
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Address Line | 115 E BREWSTER ST
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City | PRAIRIE FARM
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State | WI
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Zip | 54762-0122
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Country | US
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Telephone | 715-455-2222
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Fax | 715-455-2223
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Authorized Official
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Title or Position | DIRECTOR/TREASURER
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Name | MRS. LINDA L AMBROSE
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Credential | EMT
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Telephone | 715-455-2222
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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 | 600-1120
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License Number State | WI
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