Provider Demographics
NPI:1750815619
Name:BOYCEVILLE COMMUNITY AMBULANCE DISTRICT
Entity Type:Organization
Organization Name:BOYCEVILLE COMMUNITY AMBULANCE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:FEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-556-7229
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-0457
Mailing Address - Country:US
Mailing Address - Phone:800-244-2345
Mailing Address - Fax:800-329-5274
Practice Address - Street 1:504 RACE ST
Practice Address - Street 2:
Practice Address - City:BOYCEVILLE
Practice Address - State:WI
Practice Address - Zip Code:54725-7521
Practice Address - Country:US
Practice Address - Phone:715-643-3911
Practice Address - Fax:715-643-3912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60010763416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport