Healthcare Provider Details

I. General information

NPI: 1487783361
Provider Name (Legal Business Name): CITY OF MILWAUKEE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W WELLS ST
MILWAUKEE WI
53233-1403
US

IV. Provider business mailing address

711 W WELLS ST
MILWAUKEE WI
53233-1403
US

V. Phone/Fax

Practice location:
  • Phone: 414-286-8948
  • Fax:
Mailing address:
  • Phone: 414-286-8948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number6001161
License Number StateWI

VIII. Authorized Official

Name: MR. SHARON PURIFOY
Title or Position: DEPUTY CHIEF EMERGENCY MEDICAL SERV
Credential: NREMT-P
Phone: 414-286-8981