Provider Demographics
NPI:1164503686
Name:VILLAGE OF SHOREWOOD HILLS
Entity Type:Organization
Organization Name:VILLAGE OF SHOREWOOD HILLS
Other - Org Name:SHOREWOOD HILLS EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMERGENCY SERVICES COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-267-2680
Mailing Address - Street 1:810 SHOREWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1008 SHOREWOOD BLVD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2115
Practice Address - Country:US
Practice Address - Phone:608-267-2680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
1012200OtherPHYSICIAN'S PLUS
22242OtherGHC
501963OtherDEAN CARE
=========011OtherBCBS
22242OtherGHC
=========-00OtherUNITY
82160Medicare ID - Type UnspecifiedMEDICARE