1073564241 NPI number — CITY OF WEST ALLIS

Table of Contents

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".




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