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General NPI Number Information
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NPI Number | 1538276266
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Entity Type | Organization
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Legal Business Name | CITY OF WATERLOO
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 12/10/2010
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Provider Practice Location Address
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Address Line | 900 INDUSTRIAL LN
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City | WATERLOO
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State | WI
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Zip | 53594-1285
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Country | US
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Telephone | 920-478-2535
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Fax | 920-478-9597
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Provider Business Mailing Address
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Address Line | PO BOX 72140
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City | CEDARBURG
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State | WI
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Zip | 53012-7340
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Country | US
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Telephone | 262-375-9610
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Fax | 262-375-9608
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MICHELLE L SCHERFF SULIK
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Credential |
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Telephone | 262-375-9610
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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 |
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License Number State |
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