Organization
OHANA AMBULANCE AND EMERGENCY MEDICAL SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BALISTER (OWNER/OPERATOR)
(262) 689-0184
Entity
Organization
Contact information
Practice address
1885 TERRACE DR, PORT WASHINGTON, WI 53074-1181
(262) 689-0184
Mailing address
PO BOX 606, PORT WASHINGTON, WI 53074-0606
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
—
—
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41360100
—
WI
Enumeration date
08/16/2005
Last updated
09/14/2011
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