Organization
BROTOLOC SOUTH, INC.
Active
Parent organization
BROTOLOC SOUTH, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
BROTOLOC SOUTH, INC.
Authorized official
DOUGLAS SVEDA (REGIONAL DIRECTOR)
(414) 543-3200
Entity
Organization
Contact information
Practice address
5812 W BURNHAM ST, WEST ALLIS, WI 53219-1524
(414) 543-3200
(414) 543-3269
Mailing address
5812 W BURNHAM ST, WEST ALLIS, WI 53219-1524
(414) 543-3200
(414) 543-3269
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
41487500
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41487500
—
WI
Enumeration date
03/11/2010
Last updated
03/12/2010
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