Provider Demographics
NPI:1790060952
Name:WITTENBERG AREA FIRE/AMBULANCE PROTECTIVE SERVICE DISTRICT INC.
Entity Type:Organization
Organization Name:WITTENBERG AREA FIRE/AMBULANCE PROTECTIVE SERVICE DISTRICT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD (DICK)
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEVERSDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-881-3998
Mailing Address - Street 1:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:WITTENBERG
Mailing Address - State:WI
Mailing Address - Zip Code:54499-0232
Mailing Address - Country:US
Mailing Address - Phone:715-793-3333
Mailing Address - Fax:715-793-1313
Practice Address - Street 1:405 S. WEBB ST.
Practice Address - Street 2:
Practice Address - City:WITTENBERG
Practice Address - State:WI
Practice Address - Zip Code:54499
Practice Address - Country:US
Practice Address - Phone:715-253-3591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60013573416L0300X
WI#66049203416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport