Provider Demographics
NPI:1578271029
Name:NORTHWESTERN MUNICIPAL EMS, INC.
Entity Type:Organization
Organization Name:NORTHWESTERN MUNICIPAL EMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GULLICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:NRP
Authorized Official - Phone:715-268-8698
Mailing Address - Street 1:150 SNOW ST
Mailing Address - Street 2:
Mailing Address - City:AMERY
Mailing Address - State:WI
Mailing Address - Zip Code:54001-1407
Mailing Address - Country:US
Mailing Address - Phone:715-268-8698
Mailing Address - Fax:715-268-2121
Practice Address - Street 1:150 SNOW ST
Practice Address - Street 2:
Practice Address - City:AMERY
Practice Address - State:WI
Practice Address - Zip Code:54001-1407
Practice Address - Country:US
Practice Address - Phone:715-268-8698
Practice Address - Fax:715-268-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance