Organization
SUPERIOR AIR-GROUND AMBULANCE SERVICES OF WISCONSIN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY PATE GODDEN (VICE PRESIDENT)
(630) 903-2401
Entity
Organization
Contact information
Practice address
211 MADISON ST, WALWORTH, WI 53184-9680
(630) 234-0170
Mailing address
395 W LAKE ST, ELMHURST, IL 60126-1508
(630) 538-1887
(630) 903-2835
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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