Provider Demographics
NPI:1487634028
Name:TOWN OF MADISON
Entity Type:Organization
Organization Name:TOWN OF MADISON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:JELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-210-7260
Mailing Address - Street 1:2120 FISH HATCHERY RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-1253
Mailing Address - Country:US
Mailing Address - Phone:608-210-7260
Mailing Address - Fax:608-210-7236
Practice Address - Street 1:2120 FISH HATCHERY RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-1253
Practice Address - Country:US
Practice Address - Phone:608-210-7260
Practice Address - Fax:608-210-7236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60011823416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport