Village of Salem Lakes Kenosha County
Organization Active NPI Land Ambulance · Trevor, WI
NPI 1144274648 · NPPES record last updated Apr 7, 2026
Key facts
- NPI
- 1144274648
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- VILLAGE OF SALEM LAKES KENOSHA COUNTY
- Practice address
- 11252 254TH CT
Trevor, WI 53179-9138 - Phone
- (262) 843-2439
- NPI assigned
- May 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Alan Carr
- Title
- Fire Chief
- Phone
- (262) 298-5632
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040618000466 | WI | Part B Supplier - Ambulance Service Supplier | 4880679596 | Practice locations: Trevor, WI |
National Provider Directory
Locations
9814 Antioch Rd
Salem, WI 53168
8339 Antioch Rd
Salem, WI 53168
Phone (262) 843-2439
11252 254th Ct
Trevor, WI 53179
Phone (262) 843-2170
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
11252 254TH CT
Trevor, WI 53179-9138
Mailing address
PO Box 6253
Carol Stream, IL 60197-6253
Other practice location 1
8339 Antioch Rd
Salem, WI 53168-9154
Phone (262) 843-2439
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41360300 | Medicaid | WI | |
| 000081041 | Other | ADVOCARE MCHMO |
Other names
- Salem Lakes Fire/Rescue
Other providers in Trevor, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.