Town of Ixonia
Organization Active NPI Land Ambulance · Ixonia, WI
NPI 1730133299 · NPPES record last updated Sep 13, 2011
Key facts
- NPI
- 1730133299
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- TOWN OF IXONIA
- Practice address
- N8320 North St
Ixonia, WI 53036-9710 - Phone
- (262) 261-2440
- NPI assigned
- May 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Matt Petrie
- Title
- Chief
- Phone
- (920) 261-2440
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051108000785 | WI | Part B Supplier - Ambulance Service Supplier | 4183642168 | Practice locations: Ixonia, WI |
National Provider Directory
Locations
N8320 North St
Ixonia, WI 53036
Phone (262) 261-2440
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
N8320 North St
Ixonia, WI 53036-9710
Mailing address
PO Box 109
Ixonia, WI 53036-0109
Phone (920) 261-2440
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41339600 | Medicaid | WI |
Other names
- Town of Ixonia Fire & EMS
Other providers in Ixonia, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2011. 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.