Provider Demographics
NPI:1902851454
Name:CAMBRIDGE AREA EMS
Entity Type:Organization
Organization Name:CAMBRIDGE AREA EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BAULDAUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-423-3511
Mailing Address - Street 1:PO BOX 272
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:WI
Mailing Address - Zip Code:53523-0272
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 W MAIN
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:WI
Practice Address - Zip Code:53523
Practice Address - Country:US
Practice Address - Phone:608-423-3511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
000088673OtherADVOCARE MCHMO
8182550OtherMEDICA
WI0101OtherJOHN DEERE
1012209OtherPHYSICIAN'S PLUS
WI41342600OtherHIRSP
WI41342600Medicaid
501377OtherDEANCARE
WI0101OtherJOHN DEERE
WI41342600OtherHIRSP
000088673Medicare ID - Type UnspecifiedMEDICARE
1012209OtherPHYSICIAN'S PLUS