Healthcare Provider Details

I. General information

NPI: 1326161340
Provider Name (Legal Business Name): CITY OF BELOIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 04/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 CHURCH STREET
BELOIT WI
53511
US

IV. Provider business mailing address

1446 N RANDALL AVENUE
JANESVILLE WI
53545
US

V. Phone/Fax

Practice location:
  • Phone: 608-364-2900
  • Fax: 608-364-2925
Mailing address:
  • Phone: 608-758-7215
  • Fax: 608-758-3216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY J LIGGETT
Title or Position: FIRE CHIEF
Credential:
Phone: 608-364-2902