MEDICARE: MEDIX AMBULANCE SERVICES, INC

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	6041320	WI

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

General Provider Information

NPI Number	:	1982603635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDIX AMBULANCE SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 652
Second Line	:	147 INDUSTRIAL DR
City	:	BURLINGTON
State	:	WI
Zip	:	53105-0652
Country	:	US
Telephone Number	:	262-763-8439
Fax Number	:

Provider Business Practice Location Address
First Line	:	147 INDUSTRIAL DR
Second Line	:
City	:	BURLINGTON
State	:	WI
Zip	:	53105-2318
Country	:	US
Telephone Number	:	262-763-8439
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. LOUIS W. DENKO
Credential	:	EMT-P
Telephone Number	:	262-763-8439

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	08/22/2020

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