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NPI Code Detail

MEDICARE: VILLAGE OF MUKWONAGO

MEDICARE: VILLAGE OF MUKWONAGO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1341600000XAmbulance

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629051412
Entity Type Code : Organization
Provider Name (Legal Business Name) : VILLAGE OF MUKWONAGO
Provider Business Mailing Address
First Line : 6400 INDUSTRIAL LOOP
Second Line :
City : GREENDALE
State : WI
Zip : 53129-2452
Country : US
Telephone Number : 414-423-4100
Fax Number : 414-423-4134
Provider Business Practice Location Address
First Line : 440 RIVERCREST CT
Second Line :
City : MUKWONAGO
State : WI
Zip : 53149-1759
Country : US
Telephone Number : 262-363-6426
Fax Number : 262-363-6454
Authorized Official
Title or Position : FIRE CHIEF
Name : JEFFREY A ROLFE
Credential : EMT
Telephone Number : 262-363-6426
Provider Enumeration Date : 11/25/2005
Last Update Date : 08/22/2020

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Directions to “VILLAGE OF MUKWONAGO ” Practice Location

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