Provider Demographics
NPI:1265187876
Name:TOWN OF DOVER
Entity type:Organization
Organization Name:TOWN OF DOVER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLNAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-886-6688
Mailing Address - Street 1:PO BOX 545
Mailing Address - Street 2:
Mailing Address - City:KANSASVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53139-0545
Mailing Address - Country:US
Mailing Address - Phone:262-886-6688
Mailing Address - Fax:
Practice Address - Street 1:23730 DURAND AVE
Practice Address - Street 2:
Practice Address - City:KANSASVILLE
Practice Address - State:WI
Practice Address - Zip Code:53139-0545
Practice Address - Country:US
Practice Address - Phone:262-886-6688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KANSASVILLE FIRE & RESCUE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-14
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI6605028OtherWISCONSIN EMS SERVICE PROVIDER