Organization
LAKEVIEW CRITICAL CARE EMS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDY ALEXANDER OLIVARES (COO)
(262) 534-7297
Entity
Organization
Contact information
Practice address
1701 SHARP RD, WATERFORD, WI 53185-5214
(262) 534-7297
(262) 534-7257
Mailing address
1701 SHARP ROAD, WATERFORD, WI 53185
(262) 221-4228
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6604929
WI
Other
Enumeration date
01/15/2013
Last updated
03/29/2024
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