GREAT DIVIDE AMBULANCE SERVICE NPI 1689787715

NPI Information

  • NPI: 1689787715
  • Provider Name: GREAT DIVIDE AMBULANCE SERVICE
  • Classification: Ambulance - 3416L0300X
  • Specialization: Land Transport
  • Entity Type: Organization
  • Address: 43555 US HIGHWAY 63
    CABLE, WI
    ZIP 54821
  • Phone: (715) 798-3094

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NPI Details

GREAT DIVIDE AMBULANCE SERVICE is a land transport ambulance in Cable, WI. GREAT DIVIDE AMBULANCE SERVICE NPI is 1689787715. The provider is registered as an organization entity type.

The provider's business location address is:

43555 US HIGHWAY 63
CABLE, WI
ZIP 54821-000
Phone: (715) 798-3094
Fax: (715) 798-4442

The provider's authorized official is Roy Bloom .
The authorized official title is Service Director and has the following contact phone number (715) 798-3094.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ground mileage, per statute mile (HCPCS:A0425)
  • Advanced life support, level 2 (als 2) (HCPCS:A0433)
  • Ambulance service, advanced life support, non-emergency transport, level 1 (als 1) (HCPCS:A0426)
  • Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) (HCPCS:A0427)
  • Specialty care transport (sct) (HCPCS:A0434)

The enumeration date for this NPI number is 8/15/2006 and was last updated on 9/16/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1341600000XAmbulanceNo
23416L0300XAmbulanceLand TransportYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1391913499019OTHERWISCONSINBCBS
241355200MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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