Provider Demographics
NPI:1508947086
Name:CITY OF JUNEAU EMERGENCY MEDICAL SERVICES
Entity type:Organization
Organization Name:CITY OF JUNEAU EMERGENCY MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-210-1023
Mailing Address - Street 1:128 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:WI
Mailing Address - Zip Code:53039-1246
Mailing Address - Country:US
Mailing Address - Phone:920-386-4813
Mailing Address - Fax:
Practice Address - Street 1:128 E CROSS ST
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:WI
Practice Address - Zip Code:53039
Practice Address - Country:US
Practice Address - Phone:920-386-4810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60010743416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41322400Medicaid