Healthcare Provider Details

I. General information

NPI: 1598750887
Provider Name (Legal Business Name): CITY OF SUN PRAIRIE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2598 WEST MAIN ST.
SUN PRAIRIE WI
53590-2247
US

IV. Provider business mailing address

300 E MAIN ST
SUN PRAIRIE WI
53590-2227
US

V. Phone/Fax

Practice location:
  • Phone: 608-837-3604
  • Fax: 608-837-3586
Mailing address:
  • Phone: 608-825-1192
  • Fax: 608-834-4302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number6001028
License Number StateWI

VIII. Authorized Official

Name: MR. NATALIE M. FEGGESTAD
Title or Position: FINCANCE DIRECTOR/TREASURER
Credential:
Phone: 608-825-1192