CLINTONVILLE AREA AMBULANCE SERVICE NPI 1962422303

NPI Information

NPI: 1962422303
Provider Name: CLINTONVILLE AREA AMBULANCE SERVICE
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 52D0921588

Address:
16 N. MAIN
CLINTONVILLE, WI
ZIP 54929
Phone: (715) 823-5967
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CLINTONVILLE AREA AMBULANCE SERVICE is a land transport ambulance in Clintonville, WI. CLINTONVILLE AREA AMBULANCE SERVICE NPI is 1962422303. The provider is registered as an organization entity type.

The provider's business location address is:

16 N. MAIN
CLINTONVILLE, WI
ZIP 54929
Phone: (715) 823-5967
Fax: (715) 823-1379

The provider's authorized official is Sheryl Lynn Wendorf .
The authorized official title is Director and has the following contact phone number (715) 823-5967.

The CLIA number assigned to this NPI record is 52D0921588 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2006 and was last updated on 1/16/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	341600000X	Ambulance		6001047	WISCONSIN	No
2	3416L0300X	Ambulance	Land Transport	6001047	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	41336000	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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