Provider Demographics
NPI:1902851108
Name:THORP AREA AMBULANCE DISTRICT
Entity Type:Organization
Organization Name:THORP AREA AMBULANCE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:EBBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-669-5292
Mailing Address - Street 1:PO BOX 558
Mailing Address - Street 2:
Mailing Address - City:THORP
Mailing Address - State:WI
Mailing Address - Zip Code:54771-0558
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 S WILSON
Practice Address - Street 2:
Practice Address - City:THORP
Practice Address - State:WI
Practice Address - Zip Code:54771
Practice Address - Country:US
Practice Address - Phone:715-669-5292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI0115OtherJOHN DEERE
WI41326300Medicaid
36266OtherHEALTH PARTNERS
8181946OtherMEDICA
WI41326300Medicaid
8181946OtherMEDICA