MEDICARE: VILLAGE OF SAUKVILLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	WI0101	OTHER		JOHN DEERE
3	000082502	OTHER		ADVOCARE MCHMO
4	41325000	OTHER	WI	HIRSP
5	1031604	OTHER		PHYSICIAN'S PLUS

General Provider Information

NPI Number	:	1710931373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE OF SAUKVILLE

Provider Business Mailing Address
First Line	:	520 W DEKORA ST
Second Line	:
City	:	SAUKVILLE
State	:	WI
Zip	:	53080-1619
Country	:	US
Telephone Number	:	262-284-9423
Fax Number	:	262-284-0775

Provider Business Practice Location Address
First Line	:	520 W DEKORA ST
Second Line	:
City	:	SAUKVILLE
State	:	WI
Zip	:	53080-1619
Country	:	US
Telephone Number	:	262-284-5800
Fax Number	:	262-284-0775

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	WILLIAM RICE
Credential	:	FIRE CHIEF
Telephone Number	:	262-375-5314

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	11/01/2021

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Directions to “VILLAGE OF SAUKVILLE ” Practice Location

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