Provider Demographics
NPI:1376627646
Name:CITY OF GREENFIELD
Entity type:Organization
Organization Name:CITY OF GREENFIELD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-329-5283
Mailing Address - Street 1:4333 S 92ND ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228-2725
Mailing Address - Country:US
Mailing Address - Phone:414-545-7946
Mailing Address - Fax:414-545-8875
Practice Address - Street 1:4333 S 92ND ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53228-2725
Practice Address - Country:US
Practice Address - Phone:414-545-7946
Practice Address - Fax:414-545-8875
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF GREENFIELD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60000213416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41319700Medicaid
WI8100011OtherPROVIDER ID
WI791590386OtherMEDICARE RAILROAD PROV ID
WI791590386OtherMEDICARE RAILROAD PROV ID
WI8100011OtherPROVIDER ID