Provider Demographics
NPI:1417061813
Name:TOWN OF LYONS
Entity Type:Organization
Organization Name:TOWN OF LYONS
Other - Org Name:TOWN OF LYONS FIRE AND RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHERFF SULIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-375-9610
Mailing Address - Street 1:PO BOX 72140
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-7340
Mailing Address - Country:US
Mailing Address - Phone:262-375-9610
Mailing Address - Fax:262-375-9608
Practice Address - Street 1:6339 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:WI
Practice Address - Zip Code:53148
Practice Address - Country:US
Practice Address - Phone:262-763-3322
Practice Address - Fax:262-763-2180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41306600Medicaid
WI41306600Medicaid