Provider Demographics
NPI:1073567848
Name:NEW GLARUS EMERGENCY MEDICAL SERVICE, INC.
Entity Type:Organization
Organization Name:NEW GLARUS EMERGENCY MEDICAL SERVICE, INC.
Other - Org Name:NEW GLARUS EMS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-527-5067
Mailing Address - Street 1:PO BOX 286
Mailing Address - Street 2:
Mailing Address - City:NEW GLARUS
Mailing Address - State:WI
Mailing Address - Zip Code:53574-0286
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW GLARUS
Practice Address - State:WI
Practice Address - Zip Code:53574-9772
Practice Address - Country:US
Practice Address - Phone:608-527-5067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41342100OtherHIRSP
000088544OtherADVOCARE MCHMO
1012335OtherPHYSICIAN'S PLUS
WI41342100Medicaid
WI0100OtherJOHN DEERE
WI41342100Medicaid
=========017OtherBCBS
1012335OtherPHYSICIAN'S PLUS