Healthcare Provider Details

I. General information

NPI: 1821616574
Provider Name (Legal Business Name): CITY OF CEDARBURG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W61N631 MEQUON AVE
CEDARBURG WI
53012-2017
US

IV. Provider business mailing address

PO BOX 49
CEDARBURG WI
53012-0049
US

V. Phone/Fax

Practice location:
  • Phone: 262-375-7630
  • Fax:
Mailing address:
  • Phone: 262-375-7600
  • Fax: 262-375-7906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRISTY MERTES
Title or Position: FINANCE DIRECTOR/TREASURER
Credential:
Phone: 262-376-3907