Organization Name: | BROOKS AMBULANCE INC |
NPI Number: | 1477537249 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEROY F BROOKS (OWNER) |
Mailing Address: | 426 E Main St Waupun |
State: | WI US |
Postal Code: | 53963 |
Phone Number: | 9203249132 |
Fax Number: | 9203240968 |
NPI Enumeration Date: | 12/05/2005 |
NPI Last Update Date: | 04/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3416L0300X |
License Number: | 601226 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Ambulance |
Taxonomy Specialization: | Land Transport |
Taxonomy Definition: |