Provider Demographics
NPI:1033209424
Name:CITY OF MADISON
Entity Type:Organization
Organization Name:CITY OF MADISON
Other - Org Name:MADISON AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY CLERK
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-598-7373
Mailing Address - Street 1:404 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MN
Mailing Address - Zip Code:56256-1237
Mailing Address - Country:US
Mailing Address - Phone:320-598-7373
Mailing Address - Fax:320-598-7376
Practice Address - Street 1:301 1ST STREET
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MN
Practice Address - Zip Code:56256
Practice Address - Country:US
Practice Address - Phone:320-598-7373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01443416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport