Organization
CITY OF ANTIGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA J VOLLMAR (BILLING SECRETARY)
(715) 623-3633
Entity
Organization
Contact information
Practice address
700 EDISON ST, ANTIGO, WI 54409-1955
(715) 623-3633
(715) 627-4761
Mailing address
700 EDISON ST, ANTIGO, WI 54409-1955
(715) 623-3633
(715) 627-4761
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
60-01340
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4135130
—
WI
01
—
590007241
RAILROAD MEDICARE
WI
Enumeration date
06/14/2006
Last updated
03/06/2012
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