Organization
TOWN OF PHELPS
Active
Other names
Phelps Area Emergency Medical Service
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLE A SELIN EMT-INTERMEDIATE TEC (EMS SUPERVISOR)
(715) 545-3538
Entity
Organization
Contact information
Practice address
4499 TOWN HALL ROAD, PHELPS, WI 54554-9273
(715) 545-3538
(715) 545-3538
Mailing address
PO BOX 72140, CEDARBURG, WI 53012-7340
(262) 375-9610
(262) 375-9608
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6001374
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41356300
—
WI
01
—
52D0985331
CLIA NUMBER
WI
01
—
6001374
STATE LICENSE #
WI
Enumeration date
09/30/2006
Last updated
04/21/2011
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