Provider Demographics
NPI:1659366979
Name:TIGERTON AREA AMBULANCE SERVICE ASSOCIATION
Entity Type:Organization
Organization Name:TIGERTON AREA AMBULANCE SERVICE ASSOCIATION
Other - Org Name:TIGERTON AREA AMBULANCE SERVICE ASSOCIATION
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:RICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-535-2222
Mailing Address - Street 1:TIGERTON AREA AMBULANCE SERVICE
Mailing Address - Street 2:780 N. BEECH ST, P.O BOX 8
Mailing Address - City:TIGERTON
Mailing Address - State:WI
Mailing Address - Zip Code:54486-0008
Mailing Address - Country:US
Mailing Address - Phone:715-535-2222
Mailing Address - Fax:
Practice Address - Street 1:TIGERTON AREA AMBULANCE SERVICE
Practice Address - Street 2:780 N. BEECH ST
Practice Address - City:TIGERTON
Practice Address - State:WI
Practice Address - Zip Code:54486-0008
Practice Address - Country:US
Practice Address - Phone:715-535-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41320900Medicaid
WI41320900Medicaid