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: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 CHURCH ST
BELOIT WI
53511-5437
US

IV. Provider business mailing address

1111 CHURCH ST
BELOIT WI
53511-5437
US

V. Phone/Fax

Practice location:
  • Phone: 608-364-2904
  • Fax:
Mailing address:
  • Phone: 608-364-2904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: TODD FARLEY
Title or Position: CHIEF
Credential:
Phone: 608-364-2902