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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