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General NPI Number Information
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NPI Number | 1750581450
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Entity Type | Organization
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Legal Business Name | OKAUCHEE FIRE DEPARTMENT
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 5060 SHADY LANE
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City | OCONOMOWOC
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State | WI
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Zip | 53066
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Country | US
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Telephone | 262-567-3585
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Fax |
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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 |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MR. DAVID R 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 | 3416A0800X
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Taxonomy Name | Air Ambulance
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License Number |
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License Number State |
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