Provider Demographics
NPI:1033457924
Name:ARCADIA AMBULANCE SERVICES BOARD
Entity Type:Organization
Organization Name:ARCADIA AMBULANCE SERVICES BOARD
Other - Org Name:ARCADIA AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEB
Authorized Official - Middle Name:
Authorized Official - Last Name:SLABY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-323-4359
Mailing Address - Street 1:464 S SAINT JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:WI
Mailing Address - Zip Code:54612-1401
Mailing Address - Country:US
Mailing Address - Phone:608-323-4359
Mailing Address - Fax:
Practice Address - Street 1:464 S SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:WI
Practice Address - Zip Code:54612-1401
Practice Address - Country:US
Practice Address - Phone:608-323-4359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60004913416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIAPPLIED FORMedicare PIN