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Organization

VILLAGE OF LISBON

Active
Other names
Town of Lisbon Emergency Medical Town of Lisbon Fire Department
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY NICKOLAUS (ADMINISTRATOR)
(262) 246-6100
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6001261
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41315400
WI
Enumeration date
08/15/2006
Last updated
06/06/2024
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