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General NPI Number Information
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NPI Number | 1154471332
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Entity Type | Organization
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Legal Business Name | LJH AMBULANCE, INC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 6329 28TH AVE
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City | KENOSHA
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State | WI
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Zip | 53143
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Country | US
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Telephone | 262-658-4422
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Fax | 262-658-2774
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Provider Business Mailing Address
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Address Line | PO BOX 1227
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City | KENOSHA
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State | WI
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Zip | 53141-1227
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Country | US
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Telephone | 262-658-4422
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | JANET HELTON
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Credential |
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Telephone | 262-658-4422
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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 | 60-01334
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License Number State | WI
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