Village of Hales Corners

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

VILLAGE OF HALES CORNERS

Doing business as

Hales Corners Fire Dept

Practice address

5635 S New Berlin Rd
Hales Corners, WI 53130-1775

Phone

(414) 529-6161

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David Sulik

Title

Billing Manager

Phone

(262) 375-9610

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HALES CORNERS FIRE DEPT Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1760597447",
    "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",
            "telephone_number": "262-375-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 S NEW BERLIN RD",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301775",
            "telephone_number": "414-529-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF HALES CORNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "SULIK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "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": "41312000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HALES CORNERS FIRE DEPT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Tubic
• Cassandra Ann Van Kleunen, D.D.S.
• Sandra M Vandomelen, SAC-IT
• Jordan Vandyck, DPT
• Village of Hales Corners
• Walgreen Co (Walgreens #07568)
• Mark Wanezek
• David Mark Weis, D.D.S.
• Mary T Wells, M.D.
• Amy Leigh Westland

• Land Ambulance in Hales Corners, WI
• Providers in Hales Corners, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.