VILLAGE OF SALEM LAKES KENOSHA COUNTY NPI 1144274648

NPI Information

NPI: 1144274648
Provider Name: VILLAGE OF SALEM LAKES KENOSHA COUNTY

Doing Business As: SALEM LAKES FIRE/RESCUE

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
11252 254TH CT
TREVOR, WI
ZIP 53179
Phone: (262) 843-2439
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VILLAGE OF SALEM LAKES KENOSHA COUNTY is a land transport ambulance in Trevor, WI. VILLAGE OF SALEM LAKES KENOSHA COUNTY NPI is 1144274648. The provider is registered as an organization entity type.
The provider Is Doing Business As Salem Lakes Fire/rescue.

The provider's business location address is:

11252 254TH CT
TREVOR, WI
ZIP 53179-138
Phone: (262) 843-2439

The provider's authorized official is Mike Slover .
The authorized official title is Chief and has the following contact phone number (262) 843-2439.

The CLIA number assigned to this NPI record is 52D0993749 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/19/2006 and was last updated on 3/17/2018.

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	3416L0300X	Ambulance	Land Transport			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	=========	OTHER		TRICARE
2	=========001	MEDICAID	ILLINOIS
3	000081041	OTHER		ADVOCARE MCHMO
4	=========018	OTHER		VALLEY HEALTH PLAN
5	41360300	MEDICAID	WISCONSIN
6	=========018	OTHER		BCBS

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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