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Organization

MOUNT CALVARY AMBULANCE SERVICE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHANIE PFEIFER (ADMINISTRATOR)
(920) 753-6086
Entity
Organization

Contact information

Practice address
999 FOND DU LAC ST, MOUNT CALVARY, WI 53057-9772
(920) 753-6086
Mailing address
PO BOX 88, MOUNT CALVARY, WI 53057-0088

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000081003
ADVOCARE MCHMO
01
11518
HERITAGE NATIONAL
01
41328000
HIRSP
WI
05
41328000
WI
Enumeration date
05/18/2006
Last updated
10/09/2012
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