Provider Demographics
NPI:1508972902
Name:VILLAGE OF WAUKESHA
Entity Type:Organization
Organization Name:VILLAGE OF WAUKESHA
Other - Org Name:TOWN OF WAUKESHA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:BUCHHOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-542-3199
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:
Practice Address - Street 1:W250S3567 CENTER RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53189-7365
Practice Address - Country:US
Practice Address - Phone:262-542-3199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41474800Medicaid
WI41474800Medicaid