Organization
MAIDEN ROCK, PLUM CITY, STOCKHOLM AREA AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT GILLES (DIRECTOR)
(715) 647-2141
Entity
Organization
Contact information
Practice address
223 1ST ST, PLUM CITY, WI 54761-9002
(715) 647-2141
Mailing address
309 MAPLE AVE W, PLUM CITY, WI 54761-9015
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41311200
—
WI
01
—
47033MA
ATRIUM
—
01
—
8181636
MEDICA
—
Enumeration date
05/18/2006
Last updated
08/22/2020
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