Provider Demographics
NPI:1457335861
Name:CITY OF NEW BERLIN
Entity Type:Organization
Organization Name:CITY OF NEW BERLIN
Other - Org Name:NEW BERLIN FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:MEIL
Authorized Official - Last Name:BERTRAM
Authorized Official - Suffix:
Authorized Official - Credentials:AUTHORIZED OFFICIAL
Authorized Official - Phone:262-785-6120
Mailing Address - Street 1:9401 W BROWN DEER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-2009
Mailing Address - Country:US
Mailing Address - Phone:414-365-9900
Mailing Address - Fax:414-365-3889
Practice Address - Street 1:16300 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-5510
Practice Address - Country:US
Practice Address - Phone:262-785-6120
Practice Address - Fax:262-785-6130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41358200Medicaid
WI000085021Medicare PIN