Provider Demographics
NPI:1598750887
Name:CITY OF SUN PRAIRIE
Entity Type:Organization
Organization Name:CITY OF SUN PRAIRIE
Other - Org Name:CITY OF SUN PRAIRIE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINCANCE DIRECTOR/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FEGGESTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-825-1192
Mailing Address - Street 1:300 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-2227
Mailing Address - Country:US
Mailing Address - Phone:608-825-1192
Mailing Address - Fax:608-834-4302
Practice Address - Street 1:2598 WEST MAIN ST.
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-2247
Practice Address - Country:US
Practice Address - Phone:608-837-3604
Practice Address - Fax:608-837-3586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60010283416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41333900Medicaid
WI94219Medicare ID - Type Unspecified
WI41333900Medicaid