1073564241 NPI number — CITY OF WEST ALLIS

Table of content: (NPI 1073564241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073564241 NPI number — CITY OF WEST ALLIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF WEST ALLIS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CITY OF WEST ALLIS FIRE DEPT AMBULANCE SERVICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073564241
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7332 W NATIONAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST ALLIS
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53214-4736
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-302-8910
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7332 W NATIONAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST ALLIS
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53214-4736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-302-8910
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
POOLER
Authorized Official First Name:
MASON
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
414-302-8904

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 41352100 . This is a "NETWORK HEALTH PLAN MAHMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 41352100 . This is a "MANAGED HEALTH MAHMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1012463 . This is a "PHYSICIAN'S PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 41352100 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 037381 . This is a "HEALTH ALLIANCE MEDICAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 41352100 . This is a "GAMP" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 5553 . This is a "NETWORK HEALTH PLAN CONVE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6283128-00 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000003962 . This is a "VITAS HEALTHCARE CORP" identifier . This identifiers is of the category "OTHER".
  • Identifier: WI0101 . This is a "JOHN DEERE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000083917 . This is a "ADVOCARE MC HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0980516 . This is a "MEDICAL ASSOCIATES HMO" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 942377 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 41352100 . This is a "HIRSP" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com