AEGIS GROUP INC NPI 1063579381

NPI Information

NPI: 1063579381
Provider Name: AEGIS GROUP INC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 52D0724753

Address:
1765 ALLOUEZ AVE
GREEN BAY, WI
ZIP 54311
Phone: (920) 469-9779
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AEGIS GROUP INC is a land transport ambulance in Green Bay, WI. AEGIS GROUP INC NPI is 1063579381. The provider is registered as an organization entity type.

The provider's business location address is:

1765 ALLOUEZ AVE
GREEN BAY, WI
ZIP 54311-645
Phone: (920) 469-9779
Fax: (920) 469-9777

The provider's authorized official is Thomas R Madigan .
The authorized official title is Ceo and has the following contact phone number (920) 469-9779.

The CLIA number assigned to this NPI record is 52D0724753 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/3/2007 and was last updated on 8/9/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	341600000X	Ambulance		6001266	WISCONSIN	No
2	3416A0800X	Ambulance	Air Transport	6001266	WISCONSIN	No
3	3416L0300X	Ambulance	Land Transport	6001266	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	590001468	OTHER	WISCONSIN	RR MEDICARE AIR AMBULANCE
2	82001	MEDICARE ID-TYPE UNSPECIFIED	WISCONSIN	GROUND AMBULANCE PROVIDER
3	85913	MEDICARE ID-TYPE UNSPECIFIED	WISCONSIN	MEDICARE AIR AMBULANCE
4	41357800	MEDICAID	WISCONSIN
5	590001468	OTHER	WISCONSIN	RR MEDICARE GROUND AMBULA
6	41312700	MEDICAID	WISCONSIN
7	4755776 TYPE 18	MEDICAID	MICHIGAN
8	4755794 TYPE 18	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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