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General NPI Number Information
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NPI Number | 1194877845
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Entity Type | Organization
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Legal Business Name | KETTLE MORAINE EMERGENCY MEDICAL SERVICES INC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/04/2009
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Provider Practice Location Address
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Address Line | 380 BLUEMOUND RD
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City | WAUKESHA
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State | WI
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Zip | 53188-1751
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Country | US
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Telephone | 262-542-9699
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Fax | 262-549-9177
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Provider Business Mailing Address
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Address Line | 380 BLUEMOUND RD
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City | WAUKESHA
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State | WI
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Zip | 53188-1751
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Country | US
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Telephone | 262-542-9699
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Fax | 262-549-9177
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JANET M WHETTAM
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Credential |
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Telephone | 262-542-9699
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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 | 6001341
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License Number State | WI
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