Organization
DANE COUNTY DISTRICT ONE EMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM R WICK (DIRECTOR)
(608) 795-9860
Entity
Organization
Contact information
Practice address
133 CRESCENT AVE, MAZOMANIE, WI 53560-0505
(608) 795-9860
(608) 795-2102
Mailing address
133 CRESCENT AVE, BOX 505, MAZOMANIE, WI 53560-0505
(608) 795-9860
(608) 795-2102
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
60-01193
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41306000
—
WI
Enumeration date
09/05/2006
Last updated
08/22/2020
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