Provider Demographics
NPI:1487742359
Name:NEW RICHMOND AREA AMBULANCE AND RESCUE SERVICE ASSOCIATION
Entity type:Organization
Organization Name:NEW RICHMOND AREA AMBULANCE AND RESCUE SERVICE ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:C
Authorized Official - Last Name:MELBY
Authorized Official - Suffix:
Authorized Official - Credentials:EMTP
Authorized Official - Phone:715-246-7700
Mailing Address - Street 1:344 S ARCH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54017-1819
Mailing Address - Country:US
Mailing Address - Phone:715-246-7700
Mailing Address - Fax:715-246-6955
Practice Address - Street 1:344 S ARCH AVE
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:WI
Practice Address - Zip Code:54017-1819
Practice Address - Country:US
Practice Address - Phone:715-246-7700
Practice Address - Fax:715-246-6955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60001313416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41336800Medicaid
WI000085360Medicare ID - Type UnspecifiedMEDICARE AMBULANCE