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General NPI Number Information
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NPI Number | 1053401018
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Entity Type | Organization
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Legal Business Name | CITY OF SOUTH MILWAUKEE
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 2424 15TH AVE
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City | SOUTH MILWAUKEE
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State | WI
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Zip | 53172-2410
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Country | US
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Telephone | 414-762-2222
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Fax | 414-762-3272
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Provider Business Mailing Address
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Address Line | 2424 15TH AVE
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City | SOUTH MILWAUKEE
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State | WI
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Zip | 53172-2410
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Country | US
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Telephone | 414-762-2222
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Fax | 414-762-3272
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | SHANNON HRDLICKA
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Credential |
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Telephone | 414-768-8191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 6000171
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License Number State | WI
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