Provider Demographics
NPI:1942257381
Name:EAST TROY AREA EMERGENCY SERVICES DISTRICT
Entity Type:Organization
Organization Name:EAST TROY AREA EMERGENCY SERVICES DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT BOARD CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:BITTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-642-4495
Mailing Address - Street 1:N8406 HWY ES
Mailing Address - Street 2:
Mailing Address - City:EAST TROY
Mailing Address - State:WI
Mailing Address - Zip Code:53120-2163
Mailing Address - Country:US
Mailing Address - Phone:262-642-4495
Mailing Address - Fax:262-642-2050
Practice Address - Street 1:N8406 HWY ES
Practice Address - Street 2:
Practice Address - City:EAST TROY
Practice Address - State:WI
Practice Address - Zip Code:53120-2163
Practice Address - Country:US
Practice Address - Phone:262-642-4495
Practice Address - Fax:262-642-2050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60007183416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP00224238OtherRAILROAD MEDICARE
WI41331800OtherH.I.R.S.P.
WI41331800Medicaid
WI41331800OtherWISCONSIN RENAL PROGRAM
WI41331800Medicaid