Provider Demographics
NPI:1598825283
Name:AQUILA CORPORATION
Entity Type:Organization
Organization Name:AQUILA CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KOHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-782-0031
Mailing Address - Street 1:3827 CREEKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636-9466
Mailing Address - Country:US
Mailing Address - Phone:608-782-0031
Mailing Address - Fax:608-782-0488
Practice Address - Street 1:3827 CREEKSIDE LN
Practice Address - Street 2:
Practice Address - City:HOLMEN
Practice Address - State:WI
Practice Address - Zip Code:54636-9466
Practice Address - Country:US
Practice Address - Phone:608-782-0031
Practice Address - Fax:608-782-0488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI004000233253001332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1325110001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER