Provider Demographics
NPI:1568585735
Name:PLAIN AMBULANCE
Entity Type:Organization
Organization Name:PLAIN AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-574-9200
Mailing Address - Street 1:PO BOX 15
Mailing Address - Street 2:
Mailing Address - City:PLAIN
Mailing Address - State:WI
Mailing Address - Zip Code:53577-0001
Mailing Address - Country:US
Mailing Address - Phone:608-546-2121
Mailing Address - Fax:608-546-2121
Practice Address - Street 1:1045 CEDAR ST.
Practice Address - Street 2:
Practice Address - City:PLAIN
Practice Address - State:WI
Practice Address - Zip Code:53577
Practice Address - Country:US
Practice Address - Phone:608-546-2121
Practice Address - Fax:608-546-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty