Provider Demographics
NPI:1487851101
Name:BELLEVILLE AREA EMERGENCY MEDICAL SERVICE
Entity Type:Organization
Organization Name:BELLEVILLE AREA EMERGENCY MEDICAL SERVICE
Other - Org Name:BELLEVILLE AREA EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:C
Authorized Official - Last Name:RORAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-375-9610
Mailing Address - Street 1:PO BOX 72140
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-7340
Mailing Address - Country:US
Mailing Address - Phone:262-375-9610
Mailing Address - Fax:
Practice Address - Street 1:480 RIVER ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53508
Practice Address - Country:US
Practice Address - Phone:608-424-6869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000080093Medicare PIN