Provider Demographics
NPI:1801818992
Name:CITY OF OSHKOSH
Entity Type:Organization
Organization Name:CITY OF OSHKOSH
Other - Org Name:CITY OF OSHKOSH AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-236-5009
Mailing Address - Street 1:215 CHURCH AVENUE
Mailing Address - Street 2:P O BOX 1128
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54903-1128
Mailing Address - Country:US
Mailing Address - Phone:920-236-5009
Mailing Address - Fax:920-236-5039
Practice Address - Street 1:215 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-4747
Practice Address - Country:US
Practice Address - Phone:920-236-5009
Practice Address - Fax:920-236-5039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI590094854OtherRAILROAD MEDICARE
WI41338200Medicaid
WI000085531Medicare PIN