Footville EMS Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

FOOTVILLE EMS SERVICE

Practice address

252 N Gilbert Street
Footville, WI 53537

Phone

(262) 375-9610

NPI assigned

Dec 6, 2007

Last updated

Dec 6, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David SulikNPI 1760602072

Title

Oper MGR

Phone

(262) 375-9610

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Footville EMS Service2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Footville Fire Dept & EMS

  • Land Ambulance
  • Footville, WI
  • NPI 1003019704
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Sulik, MANAGER

  • Land Ambulance
  • Footville, WI
  • NPI 1760602072

  Land Transport

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196899200000",
    "number": "1144403759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72140",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530127340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 N GILBERT STREET",
            "city": "FOOTVILLE",
            "state": "WI",
            "postal_code": "53537",
            "telephone_number": "262-375-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTVILLE EMS SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A",
        "authorized_official_last_name": "SULIK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OPER MGR",
        "authorized_official_telephone_number": "262-375-9610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41350800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Footville Fire Dept & EMS
• Osl Sem Operating LLC (Prairie View Manor)
• St. Elizabeth Manor, Inc.
• David Sulik, MANAGER

• Land Ambulance in Footville, WI
• Providers in Footville, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.