Provider Demographics
NPI:1801097902
Name:AVOCA & RURAL FIRE & EMS DISTRICT
Entity type:Organization
Organization Name:AVOCA & RURAL FIRE & EMS DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF/DIRCTOR OF SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:KAMMERUDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-475-4039
Mailing Address - Street 1:PO BOX 192
Mailing Address - Street 2:
Mailing Address - City:AVOCA
Mailing Address - State:WI
Mailing Address - Zip Code:53506-0192
Mailing Address - Country:US
Mailing Address - Phone:608-475-4039
Mailing Address - Fax:
Practice Address - Street 1:406 EAST MAIN STREET
Practice Address - Street 2:PO 178
Practice Address - City:AVOCA
Practice Address - State:WI
Practice Address - Zip Code:53506-0178
Practice Address - Country:US
Practice Address - Phone:608-532-6510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60-013733416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41353900Medicaid
WI41353900Medicaid