MEDICARE: UNION GROVE YORKVILLE FIRE RESCUE

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

General Provider Information

NPI Number	:	1992759161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNION GROVE YORKVILLE FIRE RESCUE

Provider Business Mailing Address
First Line	:	700 MAIN ST
Second Line	:
City	:	UNION GROVE
State	:	WI
Zip	:	53182-1048
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 MAIN ST
Second Line	:
City	:	UNION GROVE
State	:	WI
Zip	:	53182-1048
Country	:	US
Telephone Number	:	262-878-4181
Fax Number	:

Authorized Official
Title or Position	:	CHIEF
Name	:	TIMOTHY ALLEN
Credential	:
Telephone Number	:	262-878-4181

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	11/25/2025

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