# MILWAUKEE REGIONAL MEDICAL CENTER INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Flight For Life
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487798740
- **Authorized official:** JOHN SMEATON (CONTROLLER)
- **Authorized official phone:** (414) 778-5929

## Contact information

- **Practice address:** 2661 AVIATION RD, WAUKESHA, WI 53188-6903
- **Practice address phone:** (414) 778-4570
- **Practice address fax:** (414) 778-5431
- **Mailing address:** 2661 AVIATION RD, WAUKESHA, WI 53188-6903
- **Mailing address phone:** (414) 778-4570
- **Mailing address fax:** (414) 778-5431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416A0800X | Air Ambulance | 9 792301 | IL | Yes |

## Other

- **Enumeration date:** 02/19/2007
- **Last updated:** 11/02/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0005623888 | BCBS PROVIDER NUMBER | IL |
| 01 | — | 324329 | PTAN | IL |