Organization
EDGAR VOLUNTEER FIRE DEPT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE HALVORSEN (EMS BILLING SECRETARY)
(531) 895-5853
Entity
Organization
Contact information
Practice address
108 BEECH ST, BOX 123, EDGAR, WI 54426-0123
(715) 352-2892
(715) 352-2892
Mailing address
10802 FARNAM DR, OMAHA, NE 68154-3237
(531) 895-5853
(877) 343-0131
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6000119
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000081761
MEDICARE PROVIDER PTAN
WI
01
—
3416L0300X
MEDICAID TAXONOMY CODE
WI
05
—
41327500
—
WI
Enumeration date
02/26/2007
Last updated
10/15/2025
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