Organization
LODI AREA EMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE EBERDT (DIRECTOR)
(608) 592-7123
Entity
Organization
Contact information
Practice address
715 N MAIN ST, LODI, WI 53555-1259
(608) 592-7123
Mailing address
715 N MAIN ST, LODI, WI 53555-1259
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012184
PHYSICIAN'S PLUS
—
01
—
41315900
HIRSP
WI
05
—
41315900
—
WI
Enumeration date
05/20/2006
Last updated
08/22/2020
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