Dallas Area Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

600-1120 Issued in WI

Legal business name

DALLAS AREA AMBULANCE SERVICE

Practice address

210 E Newsom St
Prairie Farm, WI 54762-9714

Phone

(715) 455-1575

NPI assigned

Oct 27, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Arlene Elizabeth Guldvog, EMT BASIC

Title

Director

Phone

(715) 455-1575

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1386720159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E NEWSOM ST",
            "city": "PRAIRIE FARM",
            "state": "WI",
            "postal_code": "547629714",
            "telephone_number": "715-455-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E NEWSOM ST",
            "city": "PRAIRIE FARM",
            "state": "WI",
            "postal_code": "547629714",
            "telephone_number": "715-455-1575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS AREA AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "GULDVOG",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-455-1575",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "EMT BASIC"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "600-1120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41333400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia Marie Bruder, LMT
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• Dallas Area Ambulance Service
• Adam Keapproth
• Erika Krzmarzick, COTA/L
• Tanya Leahy
• Barbara Jo Nigon

• Land Ambulance in Prairie Farm, WI
• Providers in Prairie Farm, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.