Organization
INTERSTATE EMS OF PRAIRIE DU CHIEN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELORES KUSSMAUL (EMT-INTERMEDIATE)
(608) 326-5422
Entity
Organization
Contact information
Practice address
1109 S 13TH ST, PRAIRIE DU CHIEN, WI 53821-2526
(608) 326-5422
Mailing address
PO BOX 179, PRAIRIE DU CHIEN, WI 53821-0179
(608) 326-5422
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6001361
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41353500
—
WI
Enumeration date
04/13/2006
Last updated
08/30/2010
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