Provider Demographics
NPI:1326093808
Name:PEPIN EMERGENCY AMBULANCE SERVICE
Entity type:Organization
Organization Name:PEPIN EMERGENCY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-442-2461
Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:PEPIN
Mailing Address - State:WI
Mailing Address - Zip Code:54759-0277
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:508 2ND ST
Practice Address - Street 2:
Practice Address - City:PEPIN
Practice Address - State:WI
Practice Address - Zip Code:54759-7703
Practice Address - Country:US
Practice Address - Phone:715-442-2461
Practice Address - Fax:715-245-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
000086397OtherVALLEY HEALTH PLAN
8182780OtherMEDICA
WI41339800Medicaid
000086397OtherADVOCARE MCHMO
MN623868800Medicaid