# SILVER LAKE RESCUE SQUAD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821104209
- **Authorized official:** MR. DAVID SULIK (BILLING MANAGER)
- **Authorized official phone:** (262) 375-9610

## Contact information

- **Practice address:** 209 E LAKE ST, SILVER LAKE, WI 53170
- **Practice address phone:** (262) 889-8093
- **Mailing address:** PO BOX 72140, CEDARBURG, WI 53012-7340
- **Mailing address phone:** (262) 375-9610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 10/10/2007