Provider Demographics
NPI:1518912070
Name:TOWN OF SOMERS
Entity Type:Organization
Organization Name:TOWN OF SOMERS
Other - Org Name:SOMERS RESCUE SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-859-2277
Mailing Address - Street 1:PO BOX 197
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:WI
Mailing Address - Zip Code:53171-0197
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7511 12TH ST
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:WI
Practice Address - Zip Code:53171
Practice Address - Country:US
Practice Address - Phone:262-859-2277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
41357500OtherMANAGED HEALTH
41357500OtherNETWORK HEALTH PLAN
WI41357500Medicaid
WI0100OtherJOHN DEERE
IA0716795Medicaid
IL=========001Medicaid
41357500OtherMANAGED HEALTH
WI41357500Medicaid