Provider Demographics
NPI:1659323335
Name:VILLAGE OF READSTOWN
Entity Type:Organization
Organization Name:VILLAGE OF READSTOWN
Other - Org Name:READSTOWN EMERGENCY MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-629-5100
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:READSTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:54652-0163
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:107 N RAILROAD ST
Practice Address - Street 2:
Practice Address - City:READSTOWN
Practice Address - State:WI
Practice Address - Zip Code:54652
Practice Address - Country:US
Practice Address - Phone:608-629-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN7718276-00Medicaid
WI41350900Medicaid
000085916OtherADVOCARE MCHMO
IA0504928Medicaid
WI0101OtherJOHN DEERE
1034145OtherPHYSICIAN'S PLUS
1034145OtherPHYSICIAN'S PLUS
WI0101OtherJOHN DEERE
WI41350900Medicaid
000085916Medicare ID - Type UnspecifiedMEDICARE
IA0504928Medicaid