# GREAT DIVIDE AMBULANCE SERVICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689787715
- **Authorized official:** ROY BLOOM (SERVICE DIRECTOR)
- **Authorized official phone:** (715) 798-3094

## Contact information

- **Practice address:** 43555 US HIGHWAY 63, CABLE, WI 54821-2000
- **Practice address phone:** (715) 798-3094
- **Practice address fax:** (715) 798-4442
- **Mailing address:** 43555 US HIGHWAY 63, CABLE, WI 54821-2000
- **Mailing address phone:** (715) 798-3094
- **Mailing address fax:** (336) 510-5894

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | NULL | — |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 09/16/2025