# VILLAGE OF LISBON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Town of Lisbon Emergency Medical Town of Lisbon Fire Department
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568475895
- **Authorized official:** KATHY NICKOLAUS (ADMINISTRATOR)
- **Authorized official phone:** (262) 246-6100

## Contact information

- **Practice address:** N72 W24958 GOOD HOPE ROAD, SUSSEX, WI 53089
- **Practice address phone:** (262) 538-3902
- **Practice address fax:** (262) 820-2030
- **Mailing address:** W234 N8676 WOODSIDE ROAD, SUSSEX, WI 53089-1545
- **Mailing address phone:** (262) 246-6100
- **Mailing address fax:** (262) 820-2023

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 6001261 | WI | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 06/06/2024