Organization
MENOMONEE FALLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID SULIK (BILLING MANAGER)
(262) 375-9610
Entity
Organization
Contact information
Practice address
W156N8480 PILGRIM RD, MENOMONEE FALLS, WI 53051-3140
(262) 523-8823
Mailing address
PO BOX 72140, CEDARBURG, WI 53012-7340
(262) 375-9610
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41312500
—
WI
Enumeration date
08/19/2006
Last updated
08/22/2020
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