Provider Demographics
NPI:1063524585
Name:CURTIS UNIVERSAL AMBULANCE SERVICES, INC
Entity type:Organization
Organization Name:CURTIS UNIVERSAL AMBULANCE SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-276-9890
Mailing Address - Street 1:PO BOX 2007
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53201-2007
Mailing Address - Country:US
Mailing Address - Phone:414-276-7711
Mailing Address - Fax:414-276-3291
Practice Address - Street 1:2423 W LISBON AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53205-1401
Practice Address - Country:US
Practice Address - Phone:414-933-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI66048753416L0300X
WI60-013203416L0300X
WI60-213203416L0300X
WI60-400983416L0300X
WI60-413203416L0300X
WI60-000983416L0300X
WI60-100983416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI503160OtherDEAN HEALTH
WI41319400Medicaid
WIWI1351Medicare PIN
WI000082113Medicare ID - Type UnspecifiedMEDICARE MADISON
WI791590155Medicare ID - Type UnspecifiedRR MEDICARE
WI000082491Medicare ID - Type UnspecifiedMEDICARE MILWAUKEE
WI41319400Medicaid
WI000082641Medicare ID - Type UnspecifiedMEDICARE MEDIX MILWAUKEE
WI000086568Medicare ID - Type UnspecifiedMEDICARE EDGERTON
WI000082646Medicare ID - Type UnspecifiedMEDICARE WALWORTH COUNTY
WI000082491Medicare ID - Type UnspecifiedMEDICARE MILWAUKEE