Provider Demographics
NPI:1376527358
Name:CITY OF HARTFORD TREASURER
Entity Type:Organization
Organization Name:CITY OF HARTFORD TREASURER
Other - Org Name:HARTFORD EMERGENCY SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR, TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-673-8203
Mailing Address - Street 1:109 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:WI
Mailing Address - Zip Code:53027-1521
Mailing Address - Country:US
Mailing Address - Phone:262-673-8207
Mailing Address - Fax:262-673-8301
Practice Address - Street 1:109 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-1521
Practice Address - Country:US
Practice Address - Phone:262-673-8207
Practice Address - Fax:262-673-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-02
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60-11113416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41337600Medicaid
WI590012539OtherRAILROAD MEDICARE
WI41337600Medicaid