Provider Demographics
NPI:1982603635
Name:MEDIX AMBULANCE SERVICES, INC
Entity Type:Organization
Organization Name:MEDIX AMBULANCE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:DENKO
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:262-763-8439
Mailing Address - Street 1:PO BOX 652
Mailing Address - Street 2:147 INDUSTRIAL DR
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-0652
Mailing Address - Country:US
Mailing Address - Phone:262-763-8439
Mailing Address - Fax:
Practice Address - Street 1:147 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-2318
Practice Address - Country:US
Practice Address - Phone:262-763-8439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60413203416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41346000Medicaid